Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 0968011 | NY |
NPI | 1013902634 |
---|---|
Provider Name | Sanford Abraham Ratzan |
First Address | West Islip, NY 11795-4926 |
Second Address | West Islip, NY 11795-4926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 29/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B20477 | (02) |