Basic Information
| Provider Information | |||||||||
| NPI: | 1306841838 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RANANI | ||||||||
| FirstName: | AMI | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 OLD FARM RD | ||||||||
| Address2: | |||||||||
| City: | AMAWALK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105011100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142484654 | ||||||||
| FaxNumber: | 9142775735 | ||||||||
| Practice Location | |||||||||
| Address1: | 380 ROUTE 202 | ||||||||
| Address2: | |||||||||
| City: | SOMERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105893222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142775550 | ||||||||
| FaxNumber: | 9142775735 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2005 | ||||||||
| LastUpdateDate: | 02/14/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 3503 | NY | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 0575700001 | 01 | MEDICARE DME(DURABLE MEDICAL EQUIPMENT) SUPPLIER # | OTHER |