Provider Demographics
NPI:1568590974
Name:RAFUAH TOV INC
Entity Type:Organization
Organization Name:RAFUAH TOV INC
Other - Org Name:ELDORADO MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WASSNER
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:505-466-1400
Mailing Address - Street 1:1 CALIENTE RD STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-8162
Mailing Address - Country:US
Mailing Address - Phone:505-466-1400
Mailing Address - Fax:505-466-3335
Practice Address - Street 1:1 CALIENTE RD
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-8163
Practice Address - Country:US
Practice Address - Phone:505-466-1400
Practice Address - Fax:505-466-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR56683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty