Provider Demographics
NPI:1477552248
Name:RATNER, CLIFFORD MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:MARC
Last Name:RATNER
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 1:600 MAMARONECK AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-1635
Mailing Address - Country:US
Mailing Address - Phone:914-381-4030
Mailing Address - Fax:914-381-3144
Practice Address - Street 1:600 MAMARONECK AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1635
Practice Address - Country:US
Practice Address - Phone:914-381-4030
Practice Address - Fax:914-381-3144
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207W00000X174400000X
NY133707207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00700005Medicaid
NYA5461Medicare ID - Type Unspecified
NY00700005Medicaid