Provider Demographics
NPI:1629017389
Name:RATNER, I JILL (MD)
Entity Type:Individual
Prefix:
First Name:I JILL
Middle Name:
Last Name:RATNER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:110 SOUTH BEDFORD ROAD
Mailing Address - Street 2:MOUNT KISCO MEDICAL GROUP, PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1391
Practice Address - Street 1:90 SOUTH BEDFORD ROAD
Practice Address - Street 2:MOUNT KISCO MEDICAL GROUP, PC
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3412
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-242-1391
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2016-07-20
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Provider Licenses
StateLicense IDTaxonomies
NY153304208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00863658Medicaid
NY16D3806761Medicare PIN
NY00863658Medicaid