Healthcare Provider Details

I. General information

NPI: 1083677819
Provider Name (Legal Business Name): ERIC ROLF RATNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 HOLME AVE STE 205
PHILADELPHIA PA
19152-2029
US

IV. Provider business mailing address

PO BOX 45749
BALTIMORE MD
21297-5749
US

V. Phone/Fax

Practice location:
  • Phone: 215-338-1811
  • Fax: 215-338-3606
Mailing address:
  • Phone: 215-338-1811
  • Fax: 215-338-3606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD045589L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: