MEDICARE: JILL R RATNER DO

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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	2272061	NY
2	207Q00000X	Family Medicine Physician	2272061	NY

General Provider Information

NPI Number	:	1518062330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL R RATNER DO

Provider Business Mailing Address
First Line	:	25 N RIGAUD RD
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-2533
Country	:	US
Telephone Number	:	845-356-0899
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 N RIGAUD RD
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-2533
Country	:	US
Telephone Number	:	845-356-0899
Fax Number	:

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	08/09/2011

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