Individual
DR. ERNST RAEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3001 EXPRESSWAY DRIVE NORTH, ISLANDIA, NY 11749
(631) 444-9600
Mailing address
P.O. BOX 1559, STONY BROOK, NY 11790
(631) 444-9600
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
170127
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108946
—
NY
01
—
4584863
AETNA
NY
01
—
96D54
EMPIRE BC.BS
NY
Enumeration date
07/17/2006
Last updated
07/08/2007
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