Individual
RAVELLA JAINARAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10415 211TH PL, QUEENS VILLAGE, NY 11429-1545
(917) 224-0216
Mailing address
10415 211TH PL, QUEENS VILLAGE, NY 11429-1545
(917) 224-0216
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305457-1
NY
Other
Enumeration date
09/04/2012
Last updated
09/04/2012
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