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General NPI Number Information
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NPI Number | 1790881027
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Entity Type | Individual
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Provider Name | REBECCA RAOOF MD
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Gender | Female
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1390 PENNSYLVANIA AVE
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City | BROOKLYN
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State | NY
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Zip | 11239-2103
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Country | US
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Telephone | 718-642-9855
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Fax |
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Provider Business Mailing Address
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Address Line | 14 PHEASANT HILL LN
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City | GLEN HEAD
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State | NY
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Zip | 11545-2115
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Country | US
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Telephone | 516-671-7582
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 128062
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License Number State | NY
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