Provider Demographics
NPI:1245592708
Name:RATHGEBER, JOHN PETER (MSED)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PETER
Last Name:RATHGEBER
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 1:6740 BOOTH ST
Mailing Address - Street 2:APARTMENT 3B
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2755
Mailing Address - Country:US
Mailing Address - Phone:718-997-1919
Mailing Address - Fax:
Practice Address - Street 1:6740 BOOTH ST
Practice Address - Street 2:APARTMENT 3B
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2755
Practice Address - Country:US
Practice Address - Phone:718-997-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist