Individual
MS. ERICKA RAVENELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-2985
Mailing address
487 NOBLEWOOD DR, MCDONOUGH, GA 30252-8963
(914) 424-0765
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
019650
NY
363AM0700X
Medical Physician Assistant
Primary
9660
GA
Other
Enumeration date
04/25/2016
Last updated
03/11/2021
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