Provider Demographics
NPI:1750422911
Name:MUHAMMAD, RAFEAK (MD)
Entity type:Individual
Prefix:DR
First Name:RAFEAK
Middle Name:
Last Name:MUHAMMAD
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 1:11214 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-1814
Mailing Address - Country:US
Mailing Address - Phone:718-641-6100
Mailing Address - Fax:718-738-7361
Practice Address - Street 1:11214 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1814
Practice Address - Country:US
Practice Address - Phone:718-641-6100
Practice Address - Fax:718-738-7361
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147499207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY147499-B17OtherHEALTHFIRST
NY14749901OtherNEIGHBOROOD
NY00798009Medicaid
0090711OtherGHI
B20590Medicare UPIN
NY147499-B17OtherHEALTHFIRST
NY00798009Medicaid