Provider Demographics
NPI:1225527112
Name:DOWNTOWN NEUROLOGY AND PAIN MEDICINE, PLLC
Entity Type:Organization
Organization Name:DOWNTOWN NEUROLOGY AND PAIN MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-770-0916
Mailing Address - Street 1:325 W 52ND ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6263
Mailing Address - Country:US
Mailing Address - Phone:646-549-5236
Mailing Address - Fax:
Practice Address - Street 1:39 W 29TH ST FL 11
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4249
Practice Address - Country:US
Practice Address - Phone:646-770-0916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY256815OtherMEDICAL LICENSE