Provider Demographics
NPI:1881798486
Name:RAI, DINKER
Entity type:Individual
Prefix:
First Name:DINKER
Middle Name:
Last Name:RAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 GUINEA WOODS RD
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568
Mailing Address - Country:US
Mailing Address - Phone:516-581-9412
Mailing Address - Fax:718-837-0398
Practice Address - Street 1:SUITE 108,1545 ATLANTIC AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213
Practice Address - Country:US
Practice Address - Phone:718-552-2070
Practice Address - Fax:718-613-4994
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1287292086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00335626Medicaid
NY23A792Medicare ID - Type Unspecified
D37957Medicare UPIN
NY00335626Medicaid