Basic Information
Provider Information
NPI: 1770562761
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMACHANDRAN
FirstName: MELANIE
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1001 W FAYETTE ST
Address2: STE 400
City: SYRACUSE
State: NY
PostalCode: 132042859
CountryCode: US
TelephoneNumber: 3154721488
FaxNumber: 3154728060
Practice Location
Address1: 1101 ERIE BLVD E
Address2: STE 210
City: SYRACUSE
State: NY
PostalCode: 132101144
CountryCode: US
TelephoneNumber: 3154714911
FaxNumber: 3154718024
Other Information
ProviderEnumerationDate: 01/10/2006
LastUpdateDate: 05/12/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VG0400X156666NYY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology

No ID Information.


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