Provider Demographics
NPI:1174681951
Name:BREVETTI, RAIMONDO E (MD)
Entity Type:Individual
Prefix:
First Name:RAIMONDO
Middle Name:E
Last Name:BREVETTI
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 1:1015 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3221
Mailing Address - Country:US
Mailing Address - Phone:718-836-4323
Mailing Address - Fax:718-836-4323
Practice Address - Street 1:1015 86TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3221
Practice Address - Country:US
Practice Address - Phone:718-836-4323
Practice Address - Fax:718-836-4323
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY76996207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology