Provider Demographics
NPI:1063558567
Name:ORA MEDICAL PLLC
Entity type:Organization
Organization Name:ORA MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAFAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHNAYDER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-232-5050
Mailing Address - Street 1:1120 BRIGHTON BEACH AVE
Mailing Address - Street 2:UNIT 1XZ
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5508
Mailing Address - Country:US
Mailing Address - Phone:718-232-5050
Mailing Address - Fax:718-232-1269
Practice Address - Street 1:1120 BRIGHTON BEACH AVE
Practice Address - Street 2:UNIT 1XZ
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5508
Practice Address - Country:US
Practice Address - Phone:718-232-5050
Practice Address - Fax:718-232-1269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW3X231Medicare ID - Type UnspecifiedGROUP NUMBER