Provider Demographics
NPI:1033364310
Name:RAMACHANDAR, SUJINI (MSCCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SUJINI
Middle Name:
Last Name:RAMACHANDAR
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 QUARTZ WAY
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-3408
Mailing Address - Country:US
Mailing Address - Phone:315-468-3414
Mailing Address - Fax:315-468-2089
Practice Address - Street 1:1744 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-1902
Practice Address - Country:US
Practice Address - Phone:315-468-3414
Practice Address - Fax:315-468-2089
Is Sole Proprietor?:No
Enumeration Date:2008-11-30
Last Update Date:2008-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012015-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist