Provider Demographics
NPI:1336115757
Name:RATAU, MICHELLE CYNTHIA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:CYNTHIA
Last Name:RATAU
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-2021
Mailing Address - Country:US
Mailing Address - Phone:914-831-9654
Mailing Address - Fax:
Practice Address - Street 1:2385 ARTHUR AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-8184
Practice Address - Country:US
Practice Address - Phone:718-220-9755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-25
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211701208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02089898Medicaid
NY00211701OtherMEDICAL LICENSE