Provider Demographics
NPI:1992758734
Name:MEHTA, RAVINDRA M (MD)
Entity type:Individual
Prefix:DR
First Name:RAVINDRA
Middle Name:M
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:85 BIRCHWOOD PARK DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6409
Mailing Address - Country:US
Mailing Address - Phone:516-935-2892
Mailing Address - Fax:718-630-2889
Practice Address - Street 1:800 POLY PL
Practice Address - Street 2:MEDICAL SERVICE (111)
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-630-3722
Practice Address - Fax:718-630-2889
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01055675A207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease