# DR. RAVI MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619391604
- **Authorized official:** DR. BALA RAVI MD (OWNER)
- **Authorized official phone:** (718) 497-6070

## Contact information

- **Practice address:** 6852 FRESH POND RD, RIDGEWOOD, NY 11385-5230
- **Practice address phone:** (718) 497-6070
- **Practice address fax:** (718) 497-3126
- **Mailing address:** 6852 FRESH POND RD, RIDGEWOOD, NY 11385-5230
- **Mailing address phone:** (718) 497-6070
- **Mailing address fax:** (718) 497-3126

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 208200000X | Plastic Surgery Physician | — | NULL | — |
| 208200000X | Plastic Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 02/11/2014
- **Last updated:** 02/11/2014