Intercounty Obgyn

NPI #1083785083 in Ridgewood, New York

Provider Information

NPI Number: 1083785083
Entity Type: Organization
Organization Name: Intercounty Obgyn
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Nov 13, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 6608 FRESH POND ROAD
City: Ridgewood
State: New York
ZIP Code: 11385
Phone: (718) 497-3045

Authorized Official

Name: DR. BALA KB RAVI SR., MD
Title: OWNER PHYSICIAN
Phone: (718) 497-3121

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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