Provider Demographics
NPI:1548249501
Name:DELLA RATTA, RALPH K (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:K
Last Name:DELLA RATTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:222 STATION PLAZA NORTH
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:516-663-3822
Mailing Address - Fax:516-663-4740
Practice Address - Street 1:222 STATION PLAZA NORTH
Practice Address - Street 2:SUITE 310
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501
Practice Address - Country:US
Practice Address - Phone:516-663-2051
Practice Address - Fax:516-663-4740
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYS170187207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0062964OtherGHI
5911062OtherAETNA
431683NOtherCIGNA
1307780OtherFIRSTHEALTH
759931OtherUNITED HEALTHCARE
316OtherVYTRA
AP798OtherOXFORD
110033182OtherRAILROAD MEDICARE
NY0146547Medicaid
06F171OtherBCBS
316OtherVYTRA