Individual
DIPTI RAVINDRANATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(516) 778-1634
Mailing address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(516) 778-1634
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
004104
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/16/2009
Last updated
09/11/2025
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