Provider Demographics
NPI:1245330117
Name:JILL ROBIN RATNER D.O. PLLC
Entity type:Organization
Organization Name:JILL ROBIN RATNER D.O. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:R
Authorized Official - Last Name:RATNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-445-3283
Mailing Address - Street 1:25 N RIGAUD RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-2533
Mailing Address - Country:US
Mailing Address - Phone:917-445-3283
Mailing Address - Fax:
Practice Address - Street 1:25 N RIGAUD RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-2533
Practice Address - Country:US
Practice Address - Phone:917-445-3283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227206-1207Q00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WNW231Medicare PIN