Provider Demographics
NPI:1942679105
Name:IOFFE, RAYA (LPN)
Entity Type:Individual
Prefix:
First Name:RAYA
Middle Name:
Last Name:IOFFE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 OCEAN AVE
Mailing Address - Street 2:APT-3G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3039
Mailing Address - Country:US
Mailing Address - Phone:347-697-0746
Mailing Address - Fax:
Practice Address - Street 1:1976 STUART ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2620
Practice Address - Country:US
Practice Address - Phone:347-697-0746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3120220251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care