Provider Demographics
NPI:1679001838
Name:RAMANI, PUSHPA (MBBS, DA)
Entity type:Individual
Prefix:
First Name:PUSHPA
Middle Name:
Last Name:RAMANI
Suffix:
Gender:F
Credentials:MBBS, DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2543 AVEMORE POND RD # 800394
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-7235
Mailing Address - Country:US
Mailing Address - Phone:267-640-8495
Mailing Address - Fax:
Practice Address - Street 1:2543 AVEMORE POND RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-7235
Practice Address - Country:US
Practice Address - Phone:267-640-8495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101268309208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice