Raymond Stark

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

116955 Issued in NY

Practice address

3959 Broadway
Columbia University Department Pediatrics
New York, NY 10032

Phone

(212) 927-3214

Fax

(212) 544-1974

NPI assigned

Feb 9, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366415358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 RIVERSIDE DR",
            "address_2": "#14B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251859",
            "telephone_number": "212-864-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "address_2": "COLUMBIA UNIVERSITY DEPARTMENT PEDIATRICS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-927-3214",
            "fax_number": "212-544-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "RAYMOND",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "116955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY MEDICAID",
            "identifier": "5998301",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00708452",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James William Stark, M.D.
• Jane S Stark, LCSW, CASAC
• Jeffrey David Stark, OD
• Meghan Angel Stark, MSPT, DPT
• Michael I Stark, PHD
• Richard Stark, MD
• Robin Caryl Stark, LCSW R
• Susan Stark, LCSW-R
• Yoav Stark, MD
• Heather Marie Starke, M.A., CCC-SLP

• Neonatal-Perinatal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Neonatal-Perinatal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.