Individual
DR. RAVINDRA KODALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27005 76TH AVE, 4TH FL, NEW HYDE PARK, NY 11040-1402
(718) 470-5320
Mailing address
27005 76TH AVE, 4TH FL, NEW HYDE PARK, NY 11040-1402
(718) 470-5320
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
215242
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02201238
—
NY
Enumeration date
07/18/2006
Last updated
07/19/2024
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