Provider Demographics
NPI:1477547198
Name:HOTCHANDANI, RAVI (MD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:
Last Name:HOTCHANDANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 BARNEGAT RD FL 2
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5401
Mailing Address - Country:US
Mailing Address - Phone:845-452-9800
Mailing Address - Fax:845-452-7691
Practice Address - Street 1:159 BARNEGAT RD FL 2
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-5401
Practice Address - Country:US
Practice Address - Phone:845-452-9800
Practice Address - Fax:845-452-7691
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145451207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00809009Medicaid
NYRH075K3810OtherEMPIRE BLUE CROSS BLUE SHIELD
NY75K381Medicare ID - Type Unspecified
NY100013886Medicare PIN
NYRH075K3810OtherEMPIRE BLUE CROSS BLUE SHIELD
NY75K38JW811Medicare PIN