Provider Demographics
NPI:1992742167
Name:KANT, RAVI (MD)
Entity type:Individual
Prefix:
First Name:RAVI
Middle Name:
Last Name:KANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 OLD POND RD
Mailing Address - Street 2:SUITE # 201
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1270
Mailing Address - Country:US
Mailing Address - Phone:412-220-7323
Mailing Address - Fax:412-220-7325
Practice Address - Street 1:300 OLD POND RD
Practice Address - Street 2:SUITE # 201
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1270
Practice Address - Country:US
Practice Address - Phone:412-220-7323
Practice Address - Fax:412-220-7325
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047435 L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012927050016Medicaid
PAF05331Medicare UPIN
PA0012927050016Medicaid