SUGANTHI RAVINDRAN PHYSICIAN P.C (NPI# 1912565490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912565490 |
| Entity Type | Organization |
| Organization Name | SUGANTHI RAVINDRAN PHYSICIAN P.C |
| Practice Address |
709 Hawkins Ave Ste 1 Lake Ronkonkoma NY 11779-2293 |
| Practice Telephone | 6315880880 |
| Practice Fax Number | 6315880391 |
| Mailing Telephone | 6315880880 |
| Mailing Fax Number | 6315880391 |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |
| Authorized Official Name | DR. SUGANTHI RAVINDRAN (PRESIDENT) |
| Authorized Official Telephone | 6315880880 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | HIP MEDICAID | 199922 | 01 |
| Street Address |
709 HAWKINS AVE STE 1 |
| City | LAKE RONKONKOMA |
| State | NY |
| Zip Code | 11779-2293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396804449 | Kristy A Goodman | Physical Therapist | 709 Hawkins Ave Ste 1, Lake Ronkonkoma, NY 11779-2293 | 2006-12-06 |
| 1598952830 | Allison P Rothstein | Physical Therapist | 709 Hawkins Ave Ste 1, Lake Ronkonkoma, NY 11779-2293 | 2007-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750929139 | Sebastian Godinez | Student in an Organized Health Care Education/Training Program | 11 First Street, Ronkonkoma, NY 11779 | 2019-12-16 |
| 1487149860 | John Deming | Student in an Organized Health Care Education/Training Program | 142 - 02 20th Avenue, Flushing, NY 11779 | 2018-06-27 |
| 1376060392 | Janine D'annunzio | Specialist | 316 Thirft Street, Ronkonkoma, NY 11779 | 2017-08-30 |
| 1932621935 | Vincent Joseph Lopreto | Counselor | 253 Lake Shore Road, Ronkonkoma, NY 11779 | 2017-07-11 |
| 1598295271 | Dalas Taddeo | Licensed Practical Nurse | 4490 Express Drive S, Ronkonkoma, NY 11779 | 2017-06-15 |
| 1790214112 | Pamela Ferrante | Social Worker | 131 Avenue D, Ronkonkoma, NY 11779 | 2017-06-08 |
| 1255868915 | Bari Home Care LLC | Health Maintenance Organization | 4417 Express Drive North, Ronkonkoma, NY 11779 | 2017-05-12 |
| 1013441328 | Caring Hands Home Care | Nursing Facility/Intermediate Care Facility | 65 Cheryl Drive, Ronkonkoma, NY 11779 | 2017-04-13 |
| 1831552025 | Jacqueline Galdamez | Social Worker | 979 Johnson Avenue, Ronkonkoma, NY 11779 | 2016-04-04 |
| 1891192530 | Alex Mitchell Pollack | Massage Therapist | 34 Richmond Blvd, #3a, Ronkonkoma, NY 11779 | 2014-11-24 |
| Find all providers in zip 11779 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841201282 | Bhanumathy Vinayagasundaram | Internal Medicine | 640 Hawkins Avenue, Lake Ronkonkoma, NY 11779 | 2006-08-11 |
| 1003121013 | North Shore Medical Group of Mt Sinai School of Medicine | Internal Medicine | 201 Portion Rd, Suite C, Lake Ronkonkoma, NY 11779-4172 | 2010-08-13 |
| 1023245479 | Tara K Singh | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2009-06-12 |
| 1992903264 | Manish Chadha | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2007-07-06 |
| 1033315775 | Diana Kaplinsky | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2007-06-21 |
| 1548288954 | Mickel L Khlat | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2006-07-17 |
| 1790724557 | Anang Modi | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2006-06-06 |
| 1568401826 | Joseph M Chandrankunnel | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2006-06-05 |
| 1114966306 | Marie T Pottanat | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2006-06-05 |
| 1033157912 | Michael Lee | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2006-06-03 |
| Find all providers in LAKE RONKONKOMA | ||||
| City | LAKE RONKONKOMA |
| Zip Code | 11779 |
Please comment or provide details below to improve the information on SUGANTHI RAVINDRAN PHYSICIAN P.C.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.