Mark A Raifman, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

124183 Issued in NY

Practice address

101 S Bergen PL
Freeport, NY 11520-3528

Phone

(516) 442-7179

Fax

(516) 442-7183

NPI assigned

Dec 1, 2005

Last updated

Aug 5, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Ocean Care LLC

  • Clinic/Center
  • Freeport, NY
  • NPI 1205811049
  Authorized official Same address or phone
• NHCC Medical Faculty Practice Plan PC

  dba Nassau Medical Associates

  • Internal Medicine Physician
  • Freeport, NY
  • NPI 1952541252
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1104800408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115200390",
            "telephone_number": "516-779-2390",
            "fax_number": "516-295-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S BERGEN PL",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203528",
            "telephone_number": "516-442-7179",
            "fax_number": "516-442-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIFMAN",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "124183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D0233156",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Quezada
• Ellayha Quinn, LPN
• Luis Guillermo Quinones, LMSW
• Shannon Lynda Quinton, ATC
• Lisa S Rabinowitz, R.N.
• Anika Raisa
• Timothy D Rakiec, RPH
• Perline Ramalanjaona, M.D.
• Stefanie Ramirez
• Vanessa Ramirez

• Pediatrics Physician in Freeport, NY
• Providers in Freeport, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.