Provider Demographics
NPI:1144491622
Name:BUTALIA, RAMNIK SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:RAMNIK
Middle Name:SINGH
Last Name:BUTALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 FAXON RD APT 2
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2276
Mailing Address - Country:US
Mailing Address - Phone:718-541-4068
Mailing Address - Fax:
Practice Address - Street 1:43 FAXON RD APT 2
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2276
Practice Address - Country:US
Practice Address - Phone:718-541-4068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234067282N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access