Provider Demographics
NPI:1821009986
Name:RACITI, ALFRED (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:
Last Name:RACITI
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 1:21 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2617
Mailing Address - Country:US
Mailing Address - Phone:631-744-6287
Mailing Address - Fax:631-744-1238
Practice Address - Street 1:701 ROUTE 25A
Practice Address - Street 2:SUITE B1
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-2050
Practice Address - Country:US
Practice Address - Phone:631-331-4403
Practice Address - Fax:631-331-1932
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167952207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY390006821OtherRAILROAD MEDICARE
NY0C4370OtherPHS
NY85D523OtherEMPIRE BCBS
NY01040573Medicaid
NY0255367018OtherCIGNA
NY1649OtherVYTRA
NYPRV0004506OtherMONTEFIORE
NYCS221OtherOXFORD
NY4337665OtherAETNA
NY4337665OtherAETNA
NY0C4370OtherPHS