Provider Demographics
NPI:1841349339
Name:HARBATER, RAFAEL Y (DC)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:Y
Last Name:HARBATER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2171 61ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-2570
Mailing Address - Country:US
Mailing Address - Phone:718-621-2550
Mailing Address - Fax:
Practice Address - Street 1:2171 61ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-2570
Practice Address - Country:US
Practice Address - Phone:718-621-2550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX54171Medicare ID - Type Unspecified
NYX54171Medicare UPIN