Provider Demographics
NPI:1104188143
Name:RAFF, JOSEPH TZVI (MSED)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:TZVI
Last Name:RAFF
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 E BROADWAY APT 3F
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4749
Mailing Address - Country:US
Mailing Address - Phone:516-608-6013
Mailing Address - Fax:
Practice Address - Street 1:16216 UNION TPKE
Practice Address - Street 2:METRO CHILDREN'S SERVICES INC SUITE 303
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1958
Practice Address - Country:US
Practice Address - Phone:718-264-7250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY575918051174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist