Raveendranath, Brooke A

Raveendranath, Brooke A is an individual health care provider with primary practice located at 6 Executive Park Dr , Albany NY 12203-3791. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Raveendranath, Brooke A can be contacted via phone (518) 641-6319.

Contact Information

Primary practice address
6 Executive Park Dr Albany NY 12203-3791
Fax: (518) 641-6850
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 381788 New York

Profile Details

NPI number 1891849618
LBN Legal business name Raveendranath, Brooke A
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Jun 9th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1891849618 NPPES
New York MEDICAID 02848268
New York Other 000420465001
New York Other 3010992
New York Other 143259
New York Other 091210000047

Popular Providers