Healthcare Provider Details

I. General information

NPI: 1952524696
Provider Name (Legal Business Name): RADIATION THERAPISTS ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 6TH ST
BROOKLYN NY
11215-3609
US

IV. Provider business mailing address

506 6TH ST
BROOKLYN NY
11215-3609
US

V. Phone/Fax

Practice location:
  • Phone: 718-780-3677
  • Fax: 718-780-3691
Mailing address:
  • Phone: 718-780-3677
  • Fax: 718-780-3691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number5355859
License Number StateNY

VIII. Authorized Official

Name: DR. SAMEER RAFLA
Title or Position: PRESIDENT
Credential: M. D.
Phone: 718-780-3677