Suganthi Ravindran Physician P.c | |
709 Hawkins Ave Ste 1 Lake Ronkonkoma NY 11779-2293 | |
(631) 588-0880 | |
(631) 588-0391 |
Full Name | Suganthi Ravindran Physician P.c |
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Speciality | Internal Medicine |
Location | 709 Hawkins Ave Ste 1, Lake Ronkonkoma, New York |
Authorized Official Name and Position | Suganthi Ravindran (PRESIDENT) |
Authorized Official Contact | 6315880880 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Suganthi Ravindran Physician P.c 709 Hawkins Ave Ste 1 Lake Ronkonkoma NY 11779-2293 Ph: (631) 588-0880 | Suganthi Ravindran Physician P.c 709 Hawkins Ave Ste 1 Lake Ronkonkoma NY 11779-2293 Ph: (631) 588-0880 |
NPI Number | 1912565490 |
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Provider Enumeration Date | 05/30/2019 |
Last Update Date | 05/30/2019 |
Medicare PECOS PAC ID | 3173859675 |
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Medicare Enrollment ID | O20190722001495 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912565490 | NPI | - | NPPES |
199922 | Other | NY | HIP MEDICAID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Suganthi Ravindran |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1578659819 PECOS PAC ID: 5395832778 Enrollment ID: I20101117001383 |
North Shore Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Portion Rd, Suite C, Lake Ronkonkoma, NY 11779 Phone: 631-585-5959 | |
Project Samaritan Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 161 Lake Shore Rd, Lake Ronkonkoma, NY 11779 Phone: 631-306-5895 Fax: 718-657-1870 | |
Ismail Ozcan Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 95 Church St, Lake Ronkonkoma, NY 11779 Phone: 631-588-6665 Fax: 631-580-5543 | |
Theodore Fried Burford Welch & David Hauer Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 388 Hawkins Ave, Suite 1, Lake Ronkonkoma, NY 11779 Phone: 631-588-8460 Fax: 631-588-8480 | |
Lake Family Medical Practice Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Portion Rd Ste A, Lake Ronkonkoma, NY 11779 Phone: 631-981-1333 Fax: 631-981-2326 | |
Rakesh Sharma Physician Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 Portion Rd, Suite 104, Lake Ronkonkoma, NY 11779 Phone: 631-588-8393 Fax: 631-588-2312 | |
Michael Creta, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 290 Hawkins Ave, Lake Ronkonkoma, NY 11779 Phone: 631-981-0045 Fax: 631-981-1117 |