Individual
SIMA RAGUTHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., PLLC
Contact information
Practice address
11 RALPH PLACE, STATEN ISLAND, NY 10304
(718) 816-1583
Mailing address
38 GLENDALE AVE, STATEN ISLAND, NY 10304
(718) 816-1583
(718) 815-5388
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
141323
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00733073
—
NY
Enumeration date
07/21/2006
Last updated
09/09/2011
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