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Individual
PHARA DESRAVINES
Active
Individual
PHARA DESRAVINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
354035
NY
363LF0000X
Family Nurse Practitioner
Primary
354035
NY
Other
Enumeration date
05/06/2024
Last updated
07/17/2024
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