Organization
RAFAEL MEDINA, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL R. MEDINA MD (OPHTHALMOLOGIST)
(716) 882-0461
Entity
Organization
Contact information
Practice address
564 NIAGARA ST, BUFFALO, NY 14201-1108
(716) 882-0461
(716) 882-0463
Mailing address
564 NIAGARA ST, BUFFALO, NY 14201-1108
(716) 882-0461
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
212374-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02110983
—
NY
Enumeration date
07/17/2007
Last updated
12/31/2007
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