Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | C10010374 | DE |
N | 2080P0208X | Pediatric Infectious Diseases | MD424124 | PA |
NPI | 1538266564 |
---|---|
Provider Name | Dr. Karen Ann Ravin |
First Address | Wilmington, DE 19803-3607 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 16/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H49413 | (02) |