Raifman, Mark A
Raifman, Mark A is an individual health care provider with primary practice located at 101 S Bergen Pl , Freeport NY 11520-3528. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Raifman, Mark A can be contacted via phone (516) 442-7179.Contact Information
Primary practice address
101 S Bergen Pl
Freeport NY 11520-3528
Phone: (516) 442-7179
Fax: (516) 442-7183
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 124183 | New York |
Profile Details
| NPI number | 1104800408 |
|---|---|
| LBN Legal business name | Raifman, Mark A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2005 |
| Last updated | Aug 5th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104800408 | NPPES |
| New York | MEDICAID | D0233156 |
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