Individual
RAVAI P MAHENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1711 BROOKHAVEN AVE, FAR ROCKAWAY, NY 11691-4406
(718) 869-8000
Mailing address
1711 BROOKHAVEN AVE, FAR ROCKAWAY, NY 11691-4406
(718) 869-8000
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
741771
NY
163WG0000X
General Practice Registered Nurse
741771
NY
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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