Provider Demographics
NPI:1740345396
Name:R.A.F. MEDICAL PC
Entity type:Organization
Organization Name:R.A.F. MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-773-4772
Mailing Address - Street 1:8785 14TH AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3847
Mailing Address - Country:US
Mailing Address - Phone:646-773-4772
Mailing Address - Fax:
Practice Address - Street 1:8785 14TH AVE APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3847
Practice Address - Country:US
Practice Address - Phone:646-773-4772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWWQ471Medicare PIN