Provider Demographics
NPI:1114561859
Name:BINTAREEF, RAD (MD)
Entity Type:Individual
Prefix:
First Name:RAD
Middle Name:
Last Name:BINTAREEF
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 1:658 MALTA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-4105
Mailing Address - Country:US
Mailing Address - Phone:518-580-0553
Mailing Address - Fax:
Practice Address - Street 1:658 MALTA AVE STE 101
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-4105
Practice Address - Country:US
Practice Address - Phone:518-580-0553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN297928207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist