Provider Demographics
NPI:1447978978
Name:HARIRAM GANESH MEDICINE PLLC
Entity type:Organization
Organization Name:HARIRAM GANESH MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARIRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GANESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-496-1717
Mailing Address - Street 1:99 COLD SPRING RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3140
Mailing Address - Country:US
Mailing Address - Phone:516-496-1717
Mailing Address - Fax:
Practice Address - Street 1:99 COLD SPRING RD
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3140
Practice Address - Country:US
Practice Address - Phone:516-496-1717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty