MEDICARE: RAYA IOFFE LPN

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	251J00000X	Nursing Care Agency	3120220	NY

General Provider Information

NPI Number	:	1942679105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYA IOFFE LPN

Provider Business Mailing Address
First Line	:	2300 OCEAN AVE
Second Line	:	APT-3G
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3039
Country	:	US
Telephone Number	:	347-697-0746
Fax Number	:

Provider Business Practice Location Address
First Line	:	1976 STUART ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-2620
Country	:	US
Telephone Number	:	347-697-0746
Fax Number	:

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

Provider Enumeration Date	:	09/17/2015
Last Update Date	:	09/17/2015

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