Individual
MEDZDABE DESRAVINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC, MSTOM, DIPL
Contact information
Practice address
200 OLD COUNTRY RD STE 140, MINEOLA, NY 11501-4273
(516) 794-2200
Mailing address
335 OCEAN PKWY, BROOKLYN, NY 11218-4104
(718) 885-6671
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006601-01
NY
Other
Enumeration date
08/30/2019
Last updated
07/10/2024
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