Provider Demographics
NPI:1295712446
Name:RAVAL, PARTHIV V (MD)
Entity type:Individual
Prefix:DR
First Name:PARTHIV
Middle Name:V
Last Name:RAVAL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1100 CLIFTON AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3631
Mailing Address - Country:US
Mailing Address - Phone:972-614-9700
Mailing Address - Fax:973-614-9702
Practice Address - Street 1:1100 CLIFTON AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3631
Practice Address - Country:US
Practice Address - Phone:973-614-9700
Practice Address - Fax:973-614-9702
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA065370207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7852908Medicaid
NJRA023508Medicare ID - Type Unspecified
NJ7852908Medicaid