Provider Demographics
NPI:1497398440
Name:RATSON, MOSHE
Entity Type:Individual
Prefix:
First Name:MOSHE
Middle Name:
Last Name:RATSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 YORK AVE APT 26A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6872
Mailing Address - Country:US
Mailing Address - Phone:917-692-3867
Mailing Address - Fax:
Practice Address - Street 1:260 MADISON AVE # 8023
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2400
Practice Address - Country:US
Practice Address - Phone:917-692-3867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000697106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty