MEDICARE: DR. RALPH R KIRIAT MD

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	174400000X	Specialist	148276	NY

General Provider Information

NPI Number	:	1841299104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RALPH R KIRIAT MD

Provider Business Mailing Address
First Line	:	PO BOX 290613
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-0613
Country	:	US
Telephone Number	:	718-891-7400
Fax Number	:	718-891-7401

Provider Business Practice Location Address
First Line	:	3588 NOSTRAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5203
Country	:	US
Telephone Number	:	718-891-7400
Fax Number	:	718-891-7401

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	07/08/2007

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