Healthcare Provider Details

I. General information

NPI: 1891741906
Provider Name (Legal Business Name): RAVI MUNVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 ESSEX ST SUITE 403
HACKENSACK NJ
07601-8550
US

IV. Provider business mailing address

360 ESSEX ST SUITE 403
HACKENSACK NJ
07601-8550
US

V. Phone/Fax

Practice location:
  • Phone: 201-336-8090
  • Fax:
Mailing address:
  • Phone: 201-336-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number25MA07598100
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: