Healthcare Provider Details

I. General information

NPI: 1659296077
Provider Name (Legal Business Name): RA MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4864 ARTHUR KILL RD
STATEN ISLAND NY
10309-2650
US

IV. Provider business mailing address

4864 ARTHUR KILL RD
STATEN ISLAND NY
10309-2650
US

V. Phone/Fax

Practice location:
  • Phone: 929-262-2928
  • Fax:
Mailing address:
  • Phone: 929-262-2928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DOMINIQUE MURPHY
Title or Position: OFFICE MANAGER
Credential:
Phone: 929-262-2928