Provider Demographics
NPI:1578538047
Name:RAFTOPOULOS, IOANNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:IOANNIS
Middle Name:
Last Name:RAFTOPOULOS
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 1:11 HOSPITAL DR FL 3
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-6601
Mailing Address - Country:US
Mailing Address - Phone:413-535-4757
Mailing Address - Fax:413-535-4758
Practice Address - Street 1:11 HOSPITAL DR FL 3
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6601
Practice Address - Country:US
Practice Address - Phone:413-535-4757
Practice Address - Fax:413-535-4758
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045421208600000X
MA265321208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT045421OtherLICENSE NUMBER
MA265321OtherMA LICENSE