Provider Demographics
NPI:1720043383
Name:ZOBAL-RATNER, JITKA LUDMILA (MD)
Entity Type:Individual
Prefix:
First Name:JITKA
Middle Name:LUDMILA
Last Name:ZOBAL-RATNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 COVINGTON PL
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-9517
Mailing Address - Country:US
Mailing Address - Phone:518-533-6502
Mailing Address - Fax:518-533-6505
Practice Address - Street 1:920 ALBANY SHAKER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110
Practice Address - Country:US
Practice Address - Phone:518-533-6502
Practice Address - Fax:518-533-6505
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186248207WX0110X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008194Medicaid
NY000405984004OtherBLUE SHIELD
NY114422OtherWELLCARE
NY346078OtherMVP
NY0499003OtherGHI
NY01410604Medicaid
NY10006174OtherCDPHP
NY346078OtherGHI HMO
NY409B51OtherBLUE CROSS
NYCC8334Medicare PIN
NY01410604Medicaid