Individual
DR. THARAKARAM RAVISHANKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD FACE
Contact information
Practice address
997 GLEN COVE AVE, GLEN HEAD, NY 11545-1593
(516) 674-9144
(516) 674-4024
Mailing address
997 GLEN COVE AVE, GLEN HEAD, NY 11545-1593
(516) 674-9144
(516) 674-4024
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
125628
NY
Other
Enumeration date
10/04/2006
Last updated
07/26/2010
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