Healthcare Provider Details

I. General information

NPI: 1255660031
Provider Name (Legal Business Name): A M RAFI PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STOOPS DRIVE SUITE 240 SPARTAN SURGERY CENTER
MONONGAHELA PA
15063
US

IV. Provider business mailing address

100 STOOPS DR SUITE 240 SPARTAN SURGERY CENTER
MONONGAHELA PA
15063-3553
US

V. Phone/Fax

Practice location:
  • Phone: 724-483-4282
  • Fax: 724-483-4078
Mailing address:
  • Phone: 724-483-4282
  • Fax: 724-483-4078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number433281
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number707292
License Number StatePA
# 5
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number433281
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1024590010002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier1024561530001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: DR. ARIF M RAFI
Title or Position: OWNER
Credential: M.D.
Phone: 724-483-4282