Provider Demographics
NPI:1437205051
Name:RAVITZ, RISA M (MD)
Entity Type:Individual
Prefix:
First Name:RISA
Middle Name:M
Last Name:RAVITZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:363 7TH AVE FL 18
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3904
Mailing Address - Country:US
Mailing Address - Phone:917-983-1943
Mailing Address - Fax:212-504-7912
Practice Address - Street 1:363 7TH AVE FL 18
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3904
Practice Address - Country:US
Practice Address - Phone:917-983-1943
Practice Address - Fax:212-504-7912
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2568152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology