Provider Demographics
NPI:1841441250
Name:RIFKIN, PAUL LEONARD (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:LEONARD
Last Name:RIFKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:615 HOPE RD
Mailing Address - Street 2:BUILDING 5
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1277
Mailing Address - Country:US
Mailing Address - Phone:732-571-1000
Mailing Address - Fax:732-571-1000
Practice Address - Street 1:615 HOPE RD
Practice Address - Street 2:BUILDING 5
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1277
Practice Address - Country:US
Practice Address - Phone:732-571-1000
Practice Address - Fax:732-571-1000
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02941000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJRI485047Medicare PIN
NJC56466Medicare UPIN