Provider Demographics
NPI:1497987374
Name:RAVAL, HARDIP (RPH)
Entity Type:Individual
Prefix:
First Name:HARDIP
Middle Name:
Last Name:RAVAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 S WILLIAM ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5387
Mailing Address - Country:US
Mailing Address - Phone:845-783-8116
Mailing Address - Fax:845-783-1288
Practice Address - Street 1:313 S WILLIAM ST
Practice Address - Street 2:SUITE 3
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5387
Practice Address - Country:US
Practice Address - Phone:845-783-8116
Practice Address - Fax:845-783-1288
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist