Provider Demographics
NPI:1184767717
Name:RAFF, ADAM NATHANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:NATHANIEL
Last Name:RAFF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:220 E 63RD ST
Mailing Address - Street 2:SUITE LB
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7660
Mailing Address - Country:US
Mailing Address - Phone:917-369-1841
Mailing Address - Fax:866-796-9599
Practice Address - Street 1:220 E 63RD ST
Practice Address - Street 2:SUITE LB
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7660
Practice Address - Country:US
Practice Address - Phone:917-369-1841
Practice Address - Fax:866-796-9599
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2013-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2134492084F0202X, 2084P0800X
CT0517142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7Q2622Medicare ID - Type UnspecifiedPROVIDER NUMBER