Provider Demographics
NPI:1356991632
Name:RAFFIE, NAZREEN
Entity type:Individual
Prefix:
First Name:NAZREEN
Middle Name:
Last Name:RAFFIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 TUCKAHOE RD APT 10A
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5724
Mailing Address - Country:US
Mailing Address - Phone:347-445-0913
Mailing Address - Fax:
Practice Address - Street 1:7649 HEWLETT ST
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1429
Practice Address - Country:US
Practice Address - Phone:212-388-1903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009870-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant