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General NPI Number Information
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NPI Number | 1437677200
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Entity Type | Individual
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Provider Name | MADELINE RAAB PT
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Gender | Female
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 08/31/2017
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Provider Practice Location Address
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Address Line | 2088 FRONT ST
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City | EAST MEADOW
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State | NY
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Zip | 11554-1709
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Country | US
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Telephone | 516-222-2455
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Fax |
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Provider Business Mailing Address
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Address Line | 37 FAIRVIEW AVE
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City | EAST WILLISTON
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State | NY
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Zip | 11596-2019
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Country | US
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Telephone | 516-984-0977
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 042012
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License Number State | NY
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