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General NPI Number Information
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NPI Number | 1003172974
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Entity Type | Individual
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Provider Name | JONATHAN J RASOULI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 501 SEAVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3419
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Country | US
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Telephone | 718-226-4940
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Fax |
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Provider Business Mailing Address
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Address Line | 501 SEAVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3419
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Country | US
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Telephone | 718-226-4940
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 281553
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 35.135582
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License Number State | OH
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