| Ravi C Maddali, Dds, Pc | |
|
639 W 173rd St Apt 1a New York NY 10032-1426 | |
| (212) 928-4480 | |
| (212) 928-8389 |
| Full Name | Ravi C Maddali, Dds, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 639 W 173rd St Apt 1a, New York, New York |
| Authorized Official Name and Position | Ravi C Maddali (PRESIDENT) |
| Authorized Official Contact | 2129284480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ravi C Maddali, Dds, Pc 639 W 173rd St Apt 1a New York NY 10032-1426 Ph: (212) 928-4480 | Ravi C Maddali, Dds, Pc 639 W 173rd St Apt 1a New York NY 10032-1426 Ph: (212) 928-4480 |
| NPI Number | 1114178795 |
|---|---|
| Provider Enumeration Date | 10/01/2008 |
| Last Update Date | 11/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114178795 | NPI | - | NPPES |
| 00445625 | Medicaid | NY | |
| 02559039 | Medicaid | NY | |
| 01704829 | Medicaid | NY |
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