Provider Demographics
NPI:1346215092
Name:RAVO II, RICHARD CHARLES (MS, AT,C)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:CHARLES
Last Name:RAVO II
Suffix:
Gender:M
Credentials:MS, AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 HILL AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3020
Mailing Address - Country:US
Mailing Address - Phone:516-352-1390
Mailing Address - Fax:
Practice Address - Street 1:333 HILL AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3020
Practice Address - Country:US
Practice Address - Phone:516-352-1390
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer