Provider Demographics
NPI:1336201227
Name:ZOEB, RANA (MD)
Entity Type:Individual
Prefix:DR
First Name:RANA
Middle Name:
Last Name:ZOEB
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 1:74 SOUTHAVEN AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763
Mailing Address - Country:US
Mailing Address - Phone:631-447-5445
Mailing Address - Fax:631-447-7272
Practice Address - Street 1:74 SOUTHAVEN AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763
Practice Address - Country:US
Practice Address - Phone:631-447-5445
Practice Address - Fax:631-447-7272
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191474207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01553011Medicaid
NY01553011Medicaid
NY846051Medicare ID - Type Unspecified