Healthcare Provider Details

I. General information

NPI: 1992769061
Provider Name (Legal Business Name): RAZ WINIARSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 02/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 NEWKIRK AVE
BROOKLYN NY
11226-6599
US

IV. Provider business mailing address

1414 NEWKIRK AVE
BROOKLYN NY
11226-6599
US

V. Phone/Fax

Practice location:
  • Phone: 718-759-6100
  • Fax: 718-434-0070
Mailing address:
  • Phone: 718-759-6100
  • Fax: 718-434-0070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number213410
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: