Organization
RAVINE EYE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELLI L RAVINE OD (VICE PRES)
(732) 974-1400
Entity
Organization
Contact information
Practice address
1722 NEW BEDFORD RD, WALL TOWNSHIP, NJ 07719-3867
(732) 974-1400
(732) 974-2121
Mailing address
1722 NEW BEDFORD RD, WALL TOWNSHIP, NJ 07719-3867
(732) 974-1400
(732) 974-2121
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00453001
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700839743
RAILROAD MEDICARE
NJ
Enumeration date
05/19/2006
Last updated
05/06/2008
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