Individual
DR. STEFANO RAVALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-6387
Mailing address
630 W 168TH ST, BOX 4, NEW YORK, NY 10032-3725
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
209832
NY
207RC0000X
Cardiovascular Disease Physician
Primary
209832
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01729693
—
NY
Enumeration date
11/01/2006
Last updated
01/11/2016
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