Healthcare Provider Details

I. General information

NPI: 1336115757
Provider Name (Legal Business Name): MICHELLE CYNTHIA RATAU MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2016 BRONXDALE AVE STE 203
BRONX NY
10462-3365
US

IV. Provider business mailing address

4422 3RD AVE FL 4
BRONX NY
10457-2545
US

V. Phone/Fax

Practice location:
  • Phone: 718-597-0700
  • Fax: 718-597-9500
Mailing address:
  • Phone: 718-220-9755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number211701
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number211701
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: