MEDICARE: DR. PEDRO RAFAEL ROJAS M.D.

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
1	207V00000X	Obstetrics & Gynecology Physician	125894	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WP625	OTHER		OXFORD
2	188999P	OTHER		HIP
3	C31179	OTHER		HEALTHNET
4	30191	OTHER	NY	BCBS

General Provider Information

NPI Number	:	1275628877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEDRO RAFAEL ROJAS M.D.

Provider Business Mailing Address
First Line	:	430 WESTCHESTER AVE
Second Line	:	FIRST FLOOR
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-2805
Country	:	US
Telephone Number	:	914-937-6085
Fax Number	:	914-934-3253

Provider Business Practice Location Address
First Line	:	430 WESTCHESTER AVE
Second Line	:	FIRST FLOOR
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-2805
Country	:	US
Telephone Number	:	914-937-6085
Fax Number	:	914-934-3253

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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