Provider Demographics
NPI:1649263336
Name:RIFKIN, HOWARD EUGENE (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:EUGENE
Last Name:RIFKIN
Suffix:
Gender:M
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:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-0378
Mailing Address - Country:US
Mailing Address - Phone:516-791-1900
Mailing Address - Fax:516-374-4749
Practice Address - Street 1:657 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2320
Practice Address - Country:US
Practice Address - Phone:516-791-1900
Practice Address - Fax:516-374-4749
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086129207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00132843Medicaid
NY264041Medicare ID - Type Unspecified
NY00132843Medicaid