Provider Demographics
NPI:1992769061
Name:WINIARSKY, RAZ (MD)
Entity type:Individual
Prefix:
First Name:RAZ
Middle Name:
Last Name:WINIARSKY
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 1:1414 NEWKIRK AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6599
Mailing Address - Country:US
Mailing Address - Phone:718-759-6100
Mailing Address - Fax:718-434-0070
Practice Address - Street 1:1414 NEWKIRK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6599
Practice Address - Country:US
Practice Address - Phone:718-759-6100
Practice Address - Fax:718-434-0070
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213410207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400005247Medicare PIN
NYH20011Medicare UPIN