Provider Demographics
NPI:1477551091
Name:AINAPUDI, RAVI S
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:S
Last Name:AINAPUDI
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:RAVI
Other - Middle Name:
Other - Last Name:AINAPUDI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:317 MIDDLE COUNTRY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2818
Mailing Address - Country:US
Mailing Address - Phone:631-360-4000
Mailing Address - Fax:631-360-4100
Practice Address - Street 1:317 MIDDLE COUNTRY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2818
Practice Address - Country:US
Practice Address - Phone:631-360-4000
Practice Address - Fax:631-360-4100
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234383207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology