Provider Demographics
NPI:1346365293
Name:RAFAL, SETH A (MD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:A
Last Name:RAFAL
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 1:154 BEAUMONT AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTONVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02460-2330
Mailing Address - Country:US
Mailing Address - Phone:617-332-7596
Mailing Address - Fax:
Practice Address - Street 1:91 WYMAN ST
Practice Address - Street 2:
Practice Address - City:WABAN
Practice Address - State:MA
Practice Address - Zip Code:02468-1529
Practice Address - Country:US
Practice Address - Phone:617-332-7596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1570682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry