Individual ProviderDivya RaviStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1555 Long Pond Rd, Rochester, NY 14626-4122(585) 723-7746PECOS EnrollmentBased on the most recent information from CMS, provider Divya Ravi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1689245847Provider TypeIndividualFull NameRavi, DivyaCredentialMDGenderFemaleSole ProprietorNoEnumeration Date7/8/2021Last Updated7/8/2021Contact InformationPractice LocationPractice Address1555 Long Pond Rd, Rochester, NY 14626-4122Phone(585) 723-7746Fax(585) 723-7834Mailing LocationMailing Address1555 Long Pond Rd, Rochester, NY 14626-4122Phone(585) 723-7746Fax(585) 723-7834Provider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer