Provider Demographics
NPI:1891329546
Name:BOVE, RAVIT (MSED, RD, LDN)
Entity Type:Individual
Prefix:
First Name:RAVIT
Middle Name:
Last Name:BOVE
Suffix:
Gender:F
Credentials:MSED, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 HOWE ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7860
Mailing Address - Country:US
Mailing Address - Phone:646-251-2347
Mailing Address - Fax:
Practice Address - Street 1:865 HOWE ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-7860
Practice Address - Country:US
Practice Address - Phone:646-251-2347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2020-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered