Provider Demographics
NPI:1467897553
Name:RAVIPATI, PRIYA RAMESH (MD)
Entity Type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:RAMESH
Last Name:RAVIPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PRIYADARSHINI
Other - Middle Name:
Other - Last Name:PUTTANANJAPPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4110 BOWNE ST APT 4L
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5603
Mailing Address - Country:US
Mailing Address - Phone:347-824-0315
Mailing Address - Fax:
Practice Address - Street 1:4500 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2205
Practice Address - Country:US
Practice Address - Phone:718-670-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292086207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology