MEDICARE: DR. ROBERT EDWARD RAINER M.D.

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	207V00000X	Obstetrics & Gynecology Physician	130498	CA
2	207V00000X	Obstetrics & Gynecology Physician	198920	NY

General Provider Information

NPI Number	:	1093820151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT EDWARD RAINER M.D.

Provider Business Mailing Address
First Line	:	14 DEKALB AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5311
Country	:	US
Telephone Number	:	718-875-4848
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 DEKALB AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5311
Country	:	US
Telephone Number	:	718-875-4848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	01/26/2018

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