Healthcare Provider Details

I. General information

NPI: 1477552248
Provider Name (Legal Business Name): CLIFFORD MARC RATNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 04/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MAMARONECK AVE SUITE 103
HARRISON NY
10528-1635
US

IV. Provider business mailing address

600 MAMARONECK AVE SUITE 103
HARRISON NY
10528-1635
US

V. Phone/Fax

Practice location:
  • Phone: 914-381-4030
  • Fax: 914-381-3144
Mailing address:
  • Phone: 914-381-4030
  • Fax: 914-381-3144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number207W00000X
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number133707
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: