MEDICARE: JITKA LUDMILA ZOBAL-RATNER 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	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician	186248	NY
2	207W00000X	Ophthalmology Physician	186248	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
2	000405984004	OTHER	NY	BLUE SHIELD
3	114422	OTHER	NY	WELLCARE
4	346078	OTHER	NY	MVP
5	0499003	OTHER	NY	GHI
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	10006174	OTHER	NY	CDPHP
8	346078	OTHER	NY	GHI HMO
9	409B51	OTHER	NY	BLUE CROSS

General Provider Information

NPI Number	:	1720043383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JITKA LUDMILA ZOBAL-RATNER M.D.

Provider Business Mailing Address
First Line	:	523 COVINGTON PL
Second Line	:
City	:	SLINGERLANDS
State	:	NY
Zip	:	12159-9517
Country	:	US
Telephone Number	:	518-533-6502
Fax Number	:	518-533-6505

Provider Business Practice Location Address
First Line	:	920 ALBANY SHAKER RD
Second Line	:	SUITE 101
City	:	LATHAM
State	:	NY
Zip	:	12110
Country	:	US
Telephone Number	:	518-533-6502
Fax Number	:	518-533-6505

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	03/30/2023

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