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NPI Code Detail

MEDICARE: MR. VLADISLAV RAVITSKI P.T.

MEDICARE:  MR. VLADISLAV  RAVITSKI  P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist024269NY

General Provider Information

NPI Number : 1922160480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VLADISLAV RAVITSKI P.T.
Provider Business Mailing Address
First Line : 501 BRIGHTON BEACH AVE FL 2
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-6403
Country : US
Telephone Number : 929-423-7305
Fax Number :
Provider Business Practice Location Address
First Line : 501 BRIGHTON BEACH AVE FL 2
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-6403
Country : US
Telephone Number : 929-423-7305
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 01/23/2019

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