Individual
DR. MARY A. RAVELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
211 PENNINGTON AVE, PASSAIC, NJ 07055-4617
(973) 470-3000
Mailing address
211 PENNINGTON AVE, PASSAIC, NJ 07055-4617
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MA068751
NJ
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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