Provider Demographics
NPI:1083702559
Name:RAUFOV, YAKOV (MD)
Entity Type:Individual
Prefix:MR
First Name:YAKOV
Middle Name:
Last Name:RAUFOV
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 1:1701QUENTIN RD, SUITE A7
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229
Mailing Address - Country:US
Mailing Address - Phone:718-339-4448
Mailing Address - Fax:718-339-8159
Practice Address - Street 1:1701 QUENTIN RD STE A7
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1284
Practice Address - Country:US
Practice Address - Phone:718-339-4448
Practice Address - Fax:718-339-8159
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221186174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113620477OtherUNITEDHEALTHCARE
NY1138866OtherCIGNA
NY113620477Other1199
NY169185POtherHIP
NY221186-C79OtherHEALTHFIRST
NYP27276OtherOXFORD
NY113620477OtherMAGNACARE
NY3C9947OtherHEALTHFIRST
NY0100709-03OtherAMERICHOICE
NY2799485OtherGHI
NY02164987Medicaid
NY113620477OtherEMPIRE
NY72Z991OtherBLUECROSS/BLUESHILED
NY3C9947OtherHEALTHFIRST
NYH37091Medicare UPIN