Individual
DEOKI ROMONA RAGOONANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-3244
Mailing address
8268 164TH ST, JAMAICA, NY 11432-1121
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
014562
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014562
NEW YORK STATE PHYSICIAN ASSISTANT LICENSE
NY
01
—
1090200
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANT (NCCPA)
NY
Enumeration date
03/11/2011
Last updated
12/30/2013
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