Individual
DR. RAY IVANOVS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
760 BROADWAY, WOODHULL MEDICAL & MENTAL HEALTH CENTER, BROOKLYN, NY 11206
(718) 963-8000
(973) 442-1300
Mailing address
760 BROADWAY DEPARTMENT OF MANAGED CARE ROOM 2B 230, WOODHULL MEDICAL & MENTAL HEALTH CENTER, BROOKLYN, NY 11206
(718) 963-8000
(718) 630-3122
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004397
NY
Other
Enumeration date
01/04/2006
Last updated
10/03/2014
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