Provider Demographics
NPI:1477027662
Name:SHOUVAL, RONI (MD, PHD)
Entity Type:Individual
Prefix:
First Name:RONI
Middle Name:
Last Name:SHOUVAL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SDEROT HAHASKALA ST.
Mailing Address - Street 2:ENTRANCE A, APARTMENT 72
Mailing Address - City:TEL AVIV
Mailing Address - State:TEL AVIV
Mailing Address - Zip Code:6789036
Mailing Address - Country:IL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:212-639-5809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program