Organization Name: | INTERCOUNTY OBGYN |
NPI Number: | 1083785083 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BALA KB RAVI (OWNER PHYSICIAN) |
Mailing Address: | 6608 Fresh Pond Road Ridgewood |
State: | NY US |
Postal Code: | 11385 |
Phone Number: | 7184973045 |
Fax Number: | 7184973126 |
NPI Enumeration Date: | 11/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 203725 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |