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General NPI Number Information
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NPI Number | 1760504781
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Entity Type | Organization
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Legal Business Name | JOSEPH A. RAIA MD,PC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9101 4TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-6368
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Country | US
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Telephone | 718-491-0900
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Fax | 718-491-1699
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Provider Business Mailing Address
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Address Line | 9101 4TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-6368
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Country | US
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Telephone | 718-491-0900
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Fax | 718-491-1699
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH A. RAIA
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Credential | MD
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Telephone | 718-491-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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