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General NPI Number Information
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NPI Number | 1609699081
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Entity Type | Organization
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Legal Business Name | LEXIA HEALTH
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 2119 E NORRIS ST
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City | PHILADELPHIA
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State | PA
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Zip | 19125-1924
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Country | US
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Telephone | 973-400-9564
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Fax |
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Provider Business Mailing Address
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Address Line | 58 JUNIPER TER
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City | TUXEDO PARK
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State | NY
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Zip | 10987-4769
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Country | US
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Telephone | 973-400-9564
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AVINASH RAVILLA
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Credential | DO
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Telephone | 973-400-9564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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