Provider Demographics
NPI:1306947775
Name:STRAUSS, RAPHAEL EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:RAPHAEL
Middle Name:EUGENE
Last Name:STRAUSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 COMMACK RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-6021
Mailing Address - Country:US
Mailing Address - Phone:631-462-2980
Mailing Address - Fax:631-462-2982
Practice Address - Street 1:283 COMMACK RD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-6021
Practice Address - Country:US
Practice Address - Phone:631-462-2980
Practice Address - Fax:631-462-2982
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172663207K00000X, 207KA0200X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Not Answered207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Not Answered2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE97226Medicare UPIN
NY00G811Medicare ID - Type Unspecified