=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083677819
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIC ROLF RATNER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2006
-----------------------------------------------------
Last Update Date | 12/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2701 HOLME AVE STE 205
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19152-2029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-338-1811
-----------------------------------------------------
Fax | 215-338-3606
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 45749
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21297-5749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-338-1811
-----------------------------------------------------
Fax | 215-338-3606
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | MD045589L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------