Individual
INDIRA RAVISHANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
169 MINNISINK RD, TOTOWA, NJ 07512-1803
(973) 256-1700
(973) 890-4574
Mailing address
5 GEIGER LN, WARREN, NJ 07059-5639
(732) 469-0241
(973) 890-4574
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MA3665600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4499701
—
NJ
01
—
834563B1J
MEDICARE BILLING
NJ
Enumeration date
06/06/2006
Last updated
01/14/2008
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