Healthcare Provider Details

I. General information

NPI: 1932696630
Provider Name (Legal Business Name): RAVIE ABDELWAHAB ABOZAID MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2018
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

8 CHRISWELL LN
PITTSFORD NY
14534-9461
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-1384
  • Fax: 585-276-0122
Mailing address:
  • Phone: 585-545-1004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberD98630
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: