Provider Demographics
NPI:1053947127
Name:RAMKEESOON, SHANTA NIRMALA (PHARMD)
Entity type:Individual
Prefix:
First Name:SHANTA
Middle Name:NIRMALA
Last Name:RAMKEESOON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 IMPERIAL AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3945
Mailing Address - Country:US
Mailing Address - Phone:516-503-7648
Mailing Address - Fax:
Practice Address - Street 1:1537 IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3945
Practice Address - Country:US
Practice Address - Phone:516-503-7648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist