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Organization
SUMAN CHANDRA RAVURI, MD
Active
Organization
SUMAN CHANDRA RAVURI, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IMRAN HAMEED PHD (MANAGER)
(718) 604-5469
Entity
Organization
Contact information
Practice address
585 SCHENECTADY AVE, SUITE D, BROOKLYN, NY 11203-1822
(718) 604-5402
Mailing address
912 N 1ST ST, NEW HYDE PARK, NY 11040-2822
(718) 288-8203
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
239313
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043990
CONNECTICUT LICENSE
CT
01
—
239313
NEW YORK LICENSE
NY
Enumeration date
12/21/2006
Last updated
08/22/2020
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