Provider Demographics
NPI:1659377786
Name:RATZ, JEFFREY CLARK (DC,)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CLARK
Last Name:RATZ
Suffix:
Gender:M
Credentials:DC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2136 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1406
Mailing Address - Country:US
Mailing Address - Phone:516-312-9500
Mailing Address - Fax:
Practice Address - Street 1:2136 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1406
Practice Address - Country:US
Practice Address - Phone:516-312-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003831111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX20831Medicare ID - Type Unspecified