MEDICARE: DR. ROMA RAJS-NEPOMNIASHY 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
1	208100000X	Physical Medicine & Rehabilitation Physician	224436	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568689685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROMA RAJS-NEPOMNIASHY MD

Provider Business Mailing Address
First Line	:	2951 OCEAN AVE
Second Line	:	STE 2A
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3275
Country	:	US
Telephone Number	:	718-646-6706
Fax Number	:	718-646-6706

Provider Business Practice Location Address
First Line	:	1009 BRIGHTON BEACH AVE STE 1A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5606
Country	:	US
Telephone Number	:	718-332-3200
Fax Number	:	718-332-3319

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	06/08/2009

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