Basic Information
| Provider Information | |||||||||
| NPI: | 1316476484 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMAKRISHNAN | ||||||||
| FirstName: | RITHIKA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FRANKLIN TOWN BLVD | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191031240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4842742320 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3322 N BROAD ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191405185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157071800 | ||||||||
| FaxNumber: | 2157073644 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2017 | ||||||||
| LastUpdateDate: | 06/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MT213847 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD470234 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | MT213847 | 05 | PA | MEDICAID |