Provider Demographics
NPI:1376602797
Name:RAVIKUMAR, SUNITA (MD)
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:
Last Name:RAVIKUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 HARDSCRABBLE RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1802
Mailing Address - Country:US
Mailing Address - Phone:914-591-8400
Mailing Address - Fax:914-591-7367
Practice Address - Street 1:88 ASHFORD AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1812
Practice Address - Country:US
Practice Address - Phone:914-591-8400
Practice Address - Fax:914-591-7367
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148011207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY42D312Medicare ID - Type Unspecified