Provider Demographics
NPI:1801978523
Name:RAVAL, ANISHA N (OD)
Entity type:Individual
Prefix:
First Name:ANISHA
Middle Name:N
Last Name:RAVAL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:RAVAL EYE CARE ASSOCIATES
Mailing Address - Street 2:1495 OLD YORK ROAD
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-1923
Mailing Address - Country:US
Mailing Address - Phone:215-572-6098
Mailing Address - Fax:215-572-6308
Practice Address - Street 1:2329 COTTMAN AVE
Practice Address - Street 2:ROOSEVELT MALL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-1003
Practice Address - Country:US
Practice Address - Phone:215-332-7228
Practice Address - Fax:215-332-9337
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001038152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7985500OtherAETNA
PARA1449088OtherHIGHMARK BLUE SHIELD
PAU95997Medicare UPIN
PARA1449088OtherHIGHMARK BLUE SHIELD