Healthcare Provider Details

I. General information

NPI: 1437612280
Provider Name (Legal Business Name): WILLIAM J RIFKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 PARK AVE
NEW YORK NY
10065-5937
US

IV. Provider business mailing address

655 PARK AVE
NEW YORK NY
10065-5937
US

V. Phone/Fax

Practice location:
  • Phone: 212-517-9777
  • Fax:
Mailing address:
  • Phone: 212-517-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number51139
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number336980
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number51139
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: