Provider Demographics
NPI:1932348356
Name:MINEOLA PEDIATRICS P.C.
Entity Type:Organization
Organization Name:MINEOLA PEDIATRICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DILARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-873-3683
Mailing Address - Street 1:344 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3733
Mailing Address - Country:US
Mailing Address - Phone:516-873-3683
Mailing Address - Fax:516-873-3684
Practice Address - Street 1:344 1ST ST
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3733
Practice Address - Country:US
Practice Address - Phone:516-873-3683
Practice Address - Fax:516-873-3684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty