Individual
DR. MARK A RAIFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 S BERGEN PL, FREEPORT, NY 11520-3528
(516) 442-7179
(516) 442-7183
Mailing address
PO BOX 390, FREEPORT, NY 11520-0390
(516) 779-2390
(516) 295-0317
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
124183
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D0233156
—
NY
Enumeration date
12/01/2005
Last updated
08/05/2014
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