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General NPI Number Information
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NPI Number | 1952817660
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Entity Type | Organization
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Legal Business Name | OCEAN REACH INTERNAL MEDICINE, PA
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Dates
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Enumeration Date | 12/18/2017
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Last Update Date | 12/18/2017
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Provider Practice Location Address
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Address Line | 32796 OCEAN REACH DR
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City | LEWES
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State | DE
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Zip | 19958-4662
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Country | US
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Telephone | 302-644-7472
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Fax | 302-644-7462
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Provider Business Mailing Address
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Address Line | 32796 OCEAN REACH DR
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City | LEWES
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State | DE
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Zip | 19958-4662
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Country | US
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Telephone | 302-644-7472
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Fax | 302-644-7462
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Authorized Official
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Title or Position | OWNER AND OPERATOR
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Name | DR. GARY ELLIOT RAFFEL
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Credential | DO
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Telephone | 302-259-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C2-0011017
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License Number State | DE
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