Provider Demographics
NPI:1043245400
Name:RATEB, MAHMOUDSAID H (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHMOUDSAID
Middle Name:H
Last Name:RATEB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 86TH ST
Mailing Address - Street 2:APT #102
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5055
Mailing Address - Country:US
Mailing Address - Phone:718-833-8700
Mailing Address - Fax:718-833-8700
Practice Address - Street 1:345 86TH ST
Practice Address - Street 2:APT #102
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5055
Practice Address - Country:US
Practice Address - Phone:718-833-8700
Practice Address - Fax:718-833-8700
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208866207R00000X, 207RN0300X
NJ25MA07530700207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01867894Medicaid
NY3300249OtherGHI
NY164647OtherELDERPLAN NY
NYP2098567OtherOXFORD
NY000370014225OtherHEALTHPLUS NY
NYSP14206OtherCENTERCARE NOW IS FIDELIS
NY42C621Medicare ID - Type Unspecified
NY3300249OtherGHI