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Individual

DR. LARISA RAVITSKIY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5040 FOREST DR STE 200, NEW ALBANY, OH 43054-8166
(614) 585-5500
Mailing address
5040 FOREST DR STE 200, NEW ALBANY, OH 43054-8166
(614) 585-9900
(614) 585-9999

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
35092083
OH
207N00000X
Dermatology Physician
41743
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
35092083
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2901560
OH
Enumeration date
08/08/2006
Last updated
11/20/2024
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