Provider Demographics
NPI:1578045118
Name:ROBERT H RIFKIN MD LLC
Entity Type:Organization
Organization Name:ROBERT H RIFKIN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RIFKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-997-5208
Mailing Address - Street 1:PO BOX 66726
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63166-6726
Mailing Address - Country:US
Mailing Address - Phone:314-628-1423
Mailing Address - Fax:314-336-0562
Practice Address - Street 1:11477 OLDE CABIN RD STE 210
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7129
Practice Address - Country:US
Practice Address - Phone:314-997-5208
Practice Address - Fax:314-997-5368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2F832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty