=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477611655
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAISA YEGER-ARBITMAN ,MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2006
-----------------------------------------------------
Last Update Date | 02/14/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 102-10 66TH RD 1G
-----------------------------------------------------
City | FOREST HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11375-2047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-997-0658
-----------------------------------------------------
Fax | 718-275-5677
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10210 66TH RD 1G
-----------------------------------------------------
City | FOREST HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11375-2000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-997-0658
-----------------------------------------------------
Fax | 718-275-5677
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD
-----------------------------------------------------
Name | DR. RAISA YEGER-ARBITMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 718-997-0658
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 163714
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------