Provider Demographics
NPI:1336115757
Name:RATAU, MICHELLE CYNTHIA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:CYNTHIA
Last Name:RATAU
Suffix:
Gender:
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 3RD AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-2545
Mailing Address - Country:US
Mailing Address - Phone:718-220-9755
Mailing Address - Fax:
Practice Address - Street 1:2016 BRONXDALE AVE STE 203
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-3365
Practice Address - Country:US
Practice Address - Phone:718-597-0700
Practice Address - Fax:718-597-9500
Is Sole Proprietor?:No
Enumeration Date:2006-02-25
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2117012080P0006X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00211701OtherMEDICAL LICENSE
NY02089898Medicaid