Basic Information
Provider Information
NPI: 1215172648
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUSAJ
FirstName: RAMAN
MiddleName: SINGH
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 783311
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191783311
CountryCode: US
TelephoneNumber: 4848844500
FaxNumber:  
Practice Location
Address1: 1250 S CEDAR CREST BLVD
Address2: SUITE 300
City: ALLENTOWN
State: PA
PostalCode: 181036224
CountryCode: US
TelephoneNumber: 6104023110
FaxNumber: 6104023112
Other Information
ProviderEnumerationDate: 12/15/2008
LastUpdateDate: 11/23/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XMD452266PAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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