Provider Demographics
NPI:1235631409
Name:RAVITZ, ABRAHAM YESHIA
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:YESHIA
Last Name:RAVITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 55TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4025
Mailing Address - Country:US
Mailing Address - Phone:137-645-6181
Mailing Address - Fax:
Practice Address - Street 1:1051 55TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4025
Practice Address - Country:US
Practice Address - Phone:347-645-6181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst