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Organization
RAYCO MEDICAL PLLC
Active
Organization
RAYCO MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAHAN S. ROOFEH M.D. (MEDICAL DIRECTOR)
(516) 492-3309
Entity
Organization
Contact information
Practice address
2035 LAKEVILLE RD, SUITE 300, NEW HYDE PARK, NY 11040-1600
(516) 492-3309
(516) 492-3299
Mailing address
2035 LAKEVILLE RD, SUITE 300, NEW HYDE PARK, NY 11040-1600
(516) 492-3309
(516) 492-3299
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
123456789
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE PTAN
NY
Enumeration date
02/22/2012
Last updated
02/22/2012
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