Provider Demographics
NPI:1871688713
Name:RAVAL, ASHIKKUMAR A (MD)
Entity Type:Individual
Prefix:
First Name:ASHIKKUMAR
Middle Name:A
Last Name:RAVAL
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 1:313 S WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5387
Mailing Address - Country:US
Mailing Address - Phone:845-569-9662
Mailing Address - Fax:845-561-5525
Practice Address - Street 1:313 S WILLIAM ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5387
Practice Address - Country:US
Practice Address - Phone:845-569-9662
Practice Address - Fax:845-561-5525
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2073982080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine