Provider Demographics
NPI:1508899675
Name:RAVITZ, RHONDA P (OD)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:P
Last Name:RAVITZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:P
Other - Last Name:RAVITZ-FRIEDBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:509 STILLWELLS CORNER RD
Mailing Address - Street 2:E-5
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2965
Mailing Address - Country:US
Mailing Address - Phone:732-431-9333
Mailing Address - Fax:732-431-9333
Practice Address - Street 1:509 STILLWELLS CORNER
Practice Address - Street 2:SUITE E5
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2965
Practice Address - Country:US
Practice Address - Phone:732-431-9333
Practice Address - Fax:732-431-3312
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ005273152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ046413Medicare PIN
NJU54550Medicare UPIN