Healthcare Provider Details

I. General information

NPI: 1881119337
Provider Name (Legal Business Name): ANNMARIE DAWN RAEFSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2017
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 GREENLAWN RD
HUNTINGTON NY
11743-2929
US

IV. Provider business mailing address

3 LELAND ST
EAST NORTHPORT NY
11731-1924
US

V. Phone/Fax

Practice location:
  • Phone: 631-427-7685
  • Fax:
Mailing address:
  • Phone: 631-935-4131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number021559
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number021559-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: