Individual provider Active NPI

Wilfrid Noel Raby, PH.D., M.D.

  • Psychiatry Physician
  • Teaneck, NJ
National Provider Identifier
1518019900
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MA66123 Issued in NJ
Practice address
175 Cedar LN
Suite 7
Teaneck, NJ 07666-4315
Phone
(201) 801-0052
Fax
(212) 568-3832
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MA66123 NJ Primary

Addresses

Primary practice location

175 Cedar LN
Suite 7
Teaneck, NJ 07666-4315

Mailing address

4525 Henry Hudson Pkwy
Apt 304
Bronx, NY 10471-3808
Phone (718) 884-1315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
001376NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Park Slope Center for Mental Health, Inc PastSince Oct 11, 2005 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518019900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 HENRY HUDSON PKWY",
            "address_2": "APT 304",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104713808",
            "telephone_number": "718-884-1315",
            "fax_number": "212-568-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CEDAR LN",
            "address_2": "SUITE 7",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664315",
            "telephone_number": "201-801-0052",
            "fax_number": "212-568-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABY",
        "first_name": "WILFRID",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "PH.D., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MA66123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.