MEDICARE: MOSHE RATSON

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	106H00000X	Marriage & Family Therapist	000697	NY

General Provider Information

NPI Number	:	1497398440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOSHE RATSON

Provider Business Mailing Address
First Line	:	1755 YORK AVE APT 26A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-6872
Country	:	US
Telephone Number	:	917-692-3867
Fax Number	:

Provider Business Practice Location Address
First Line	:	260 MADISON AVE # 8023
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-2400
Country	:	US
Telephone Number	:	917-692-3867
Fax Number	:

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

Provider Enumeration Date	:	10/22/2019
Last Update Date	:	10/23/2019

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