Provider Demographics
NPI:1962719310
Name:ROBERT I RATTINER MD PLLC
Entity type:Organization
Organization Name:ROBERT I RATTINER MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:RATTINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-498-1965
Mailing Address - Street 1:99 HILLSIDE AVENUE
Mailing Address - Street 2:SUITE T
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596
Mailing Address - Country:US
Mailing Address - Phone:516-498-1965
Mailing Address - Fax:516-504-0235
Practice Address - Street 1:99 HILLSIDE AVENUE
Practice Address - Street 2:SUITE T
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596
Practice Address - Country:US
Practice Address - Phone:516-498-1965
Practice Address - Fax:516-504-0235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194753207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02116952Medicaid
NYA100050430Medicare PIN
NYG70913Medicare UPIN