Provider Demographics
NPI:1952415630
Name:RAKOWSKA, URSZULA KRYSTYNA (MD)
Entity Type:Individual
Prefix:DR
First Name:URSZULA
Middle Name:KRYSTYNA
Last Name:RAKOWSKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-2598
Mailing Address - Country:US
Mailing Address - Phone:631-956-7337
Mailing Address - Fax:631-956-9118
Practice Address - Street 1:150 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-2598
Practice Address - Country:US
Practice Address - Phone:631-956-7337
Practice Address - Fax:631-956-9118
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205268208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01728532Medicaid
NY01728532Medicaid
NY85X971Medicare ID - Type Unspecified