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NPI Code Detail

MEDICARE: RAPHAEL REISS, A PHYSICIAN P.C.

MEDICARE: RAPHAEL REISS, A PHYSICIAN P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist133426NY
2207V00000XObstetrics & Gynecology Physician

General Provider Information

NPI Number : 1245323815
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAPHAEL REISS, A PHYSICIAN P.C.
Provider Business Mailing Address
First Line : 69-05 YELLOWSTONE BLVD.
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-3753
Country : US
Telephone Number : 718-544-8400
Fax Number : 718-263-5401
Provider Business Practice Location Address
First Line : 69-05 YELLOWSTONE BLVD.
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-3753
Country : US
Telephone Number : 718-544-8400
Fax Number : 718-263-5401
Authorized Official
Title or Position : PRESIDENT
Name : DR. RAPHAEL REISS
Credential : M.D.
Telephone Number : 718-544-8400
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/18/2022

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Directions to “RAPHAEL REISS, A PHYSICIAN P.C. ” Practice Location

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