Individual ProviderRavi R SalickramPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address554 Tompkins Ave, Staten Island, NY 10305-1745(347) 855-7284PECOS EnrollmentBased on the most recent information from CMS, provider Ravi R Salickram does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1508992017Provider TypeIndividualFull NameSalickram, Ravi RCredentialRPAGenderMaleSole ProprietorNoEnumeration Date2/26/2007Last Updated11/20/2024Contact InformationPractice LocationPractice Address554 Tompkins Ave, Staten Island, NY 10305-1745Phone(347) 855-7284Fax(631) 883-8496Mailing LocationMailing Address554 Tompkins Ave, Staten Island, NY 10305-1745Phone(347) 855-7284Fax(631) 883-8496Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense012971New YorkCode363AM0700XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseP54318New York