Medina, Rafael

Medina, Rafael is an individual health care provider with primary practice located at 1 Atwell Rd , Cooperstown NY 13326-1301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Medina, Rafael can be contacted via phone (607) 547-6960.

Contact Information

Primary practice address
1 Atwell Rd Cooperstown NY 13326-1301
Fax: (607) 547-6574
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 212374-1 New York

Profile Details

NPI number 1265416598
LBN Legal business name Medina, Rafael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Jul 6th, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265416598 NPPES
New York MEDICAID 02110983

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