Individual
JUAN RAVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
360 ESSEX ST STE 302, HACKENSACK, NJ 07601-8566
(551) 996-2065
Mailing address
10 CENTER DRIVE, BG 10 RM 12C103, BETHESDA, MD 20814
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
25MA10848800
NJ
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
D73924
MD
Other
Enumeration date
09/07/2009
Last updated
06/16/2020
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