Individual
MRS. CHITHKALA RAVISHANKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD CDE
Contact information
Practice address
997 GLEN COVE AVE, GLEN HEAD, NY 11545-1593
(516) 674-9144
(516) 674-4024
Mailing address
31 GREEN DR, ROSLYN, NY 11576-3208
(516) 674-9144
(516) 674-4024
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
004375
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03P92EY561
PTAN
NY
Enumeration date
10/04/2006
Last updated
05/24/2015
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