Provider Demographics
NPI:1497838460
Name:RAFTOPOL, ELENA I (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:I
Last Name:RAFTOPOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-1352
Mailing Address - Country:US
Mailing Address - Phone:914-665-0066
Mailing Address - Fax:
Practice Address - Street 1:10 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5214
Practice Address - Country:US
Practice Address - Phone:914-637-3510
Practice Address - Fax:914-819-0061
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134044207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00492484Medicaid
NY0650BCMedicare PIN
NY02255VMedicare PIN
NYC08567Medicare UPIN
NY00492484Medicaid
NY33A111Medicare PIN