1679603864 NPI number — DEBORAH G RAVINSKI D.C.

Table of content: DEBORAH G RAVINSKI D.C. (NPI 1679603864)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679603864 NPI number — DEBORAH G RAVINSKI D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAVINSKI
Provider First Name:
DEBORAH
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679603864
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2277 STATE RD
Provider Second Line Business Mailing Address:
STE 1
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02360-7111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-833-6420
Provider Business Mailing Address Fax Number:
508-833-6421

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2277 STATE RD
Provider Second Line Business Practice Location Address:
STE 1
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02360-7111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-833-6420
Provider Business Practice Location Address Fax Number:
508-833-6421
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1664 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Y36187 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com