Individual
RAY CHAVDAR REZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
656 PENNSYLVANIA AVE, BROOKLYN, NY 11207-6907
(718) 342-2446
(718) 591-0265
Mailing address
6310 FRESH POND RD, RIDGEWOOD, NY 11385-2624
(347) 229-5117
(718) 342-4033
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
010061
NY
Other
Enumeration date
09/29/2009
Last updated
09/29/2009
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