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NPI Code Detail

MEDICARE: ALLISON PORTIA RATHAN MD

MEDICARE: ALLISON PORTIA RATHAN MD
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
1207R00000XInternal Medicine Physician192459NY
2207R00000XInternal Medicine Physician25MA07850800NJ

General Provider Information

NPI Number : 1467447862
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON PORTIA RATHAN MD
Provider Business Mailing Address
First Line : 1250 57TH STREET
Second Line : MAIMONIDES ADULT PRIMARY CARE CLINIC
City : BROOKLYN
State : NY
Zip : 11219
Country : US
Telephone Number : 718-283-5700
Fax Number :
Provider Business Practice Location Address
First Line : 1250 57TH ST
Second Line : MAIMONIDES ADULT PRIMARY CARE CLINIC
City : BROOKLYN
State : NY
Zip : 11219-4537
Country : US
Telephone Number : 718-283-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 01/16/2014

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Directions to “ ALLISON PORTIA RATHAN MD” Practice Location

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