MEDICARE: ORA MEDICAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1063558567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORA MEDICAL PLLC

Provider Business Mailing Address
First Line	:	1120 BRIGHTON BEACH AVE
Second Line	:	UNIT 1XZ
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5508
Country	:	US
Telephone Number	:	718-232-5050
Fax Number	:	718-232-1269

Provider Business Practice Location Address
First Line	:	1120 BRIGHTON BEACH AVE
Second Line	:	UNIT 1XZ
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5508
Country	:	US
Telephone Number	:	718-232-5050
Fax Number	:	718-232-1269

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	RAFAIL SHNAYDER
Credential	:	D.O.
Telephone Number	:	718-232-5050

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	01/31/2011

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