Organization
T.RAVISHANKAR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. T RAVISHANKAR MD PC (PRESIDENT)
(516) 674-9144
Entity
Organization
Contact information
Practice address
997 GLEN COVE AVE, GLEN HEAD, NY 11545-1593
(516) 674-9144
(516) 674-4024
Mailing address
997 GLEN COVE AVE, GLEN HEAD, NY 11545-1593
(516) 674-9144
(516) 674-4024
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
125628
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004375
LICENSE FOR NUTRITIONIST
NY
Enumeration date
12/15/2006
Last updated
05/11/2009
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