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General NPI Number Information
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NPI Number | 1497839799
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Entity Type | Organization
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Legal Business Name | YAKOV RAUFOV MEDICAL PC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 2626 E 14TH ST STE 204
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City | BROOKLYN
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State | NY
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Zip | 11235-3968
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Country | US
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Telephone | 718-339-4448
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Fax |
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Provider Business Mailing Address
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Address Line | 2066 W 5TH ST
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City | BROOKLYN
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State | NY
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Zip | 11223-3835
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Country | US
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Telephone | 718-339-4448
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Fax | 718-339-8159
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ANNA LOSHINSKY
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Credential |
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Telephone | 718-339-4448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 221186
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License Number State | NY
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