Provider Demographics
NPI:1265454482
Name:RABER, JAMES H (NP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:RABER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2658 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWFANE
Mailing Address - State:NY
Mailing Address - Zip Code:14108-1033
Mailing Address - Country:US
Mailing Address - Phone:716-778-8627
Mailing Address - Fax:716-778-8059
Practice Address - Street 1:2658 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWFANE
Practice Address - State:NY
Practice Address - Zip Code:14108-1033
Practice Address - Country:US
Practice Address - Phone:716-778-8627
Practice Address - Fax:716-778-8059
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333601363LP0200X
NYF333601-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040702000025OtherFIDELIS
NY00026731401OtherUNIVERA
NY9512624OtherINDEPENDENT HEALTH
NY000560682003OtherBLUE CROSS OF WNY
NYRB7355Medicare PIN