Provider Demographics
NPI:1376760579
Name:OPPENHEIMER, RAFAEL J (DPM)
Entity Type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:J
Last Name:OPPENHEIMER
Suffix:
Gender:M
Credentials:DPM
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Other - Credentials:
Mailing Address - Street 1:29 WASHINGTON ST
Mailing Address - Street 2:SUITE #702 ASHFORD MEDICAL CENTER
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907
Mailing Address - Country:US
Mailing Address - Phone:787-721-4404
Mailing Address - Fax:787-721-4699
Practice Address - Street 1:29 WASHINGTON ST
Practice Address - Street 2:SUITE #702 ASHFORD MEDICAL CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-721-4404
Practice Address - Fax:787-721-4699
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR067213ES0131X
NY067213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U62115Medicare UPIN