Organization Active NPI

Nabil and Rebecca G Raoof, MD PC

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1609171370
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
127162 Issued in NY
Legal business name
NABIL AND REBECCA G RAOOF, MD PC
Practice address
1390 Pennsylvania Ave
Brooklyn, NY 11239-2103
Phone
(718) 642-9855
Fax
(718) 599-0505
NPI assigned
Jan 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Authorized official

Name
Dr. Nabil Raoof, MD
Title
President
Phone
(718) 642-9855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 127162 NY Primary

Addresses

Primary practice location

1390 Pennsylvania Ave
Brooklyn, NY 11239-2103

Mailing address

1390 Pennsylvania Ave
Brooklyn, NY 11239-2103
Phone (718) 642-9855

Other identifiers 2

IdentifierTypeStateIssuer
00237054MedicaidNY
00237518MedicaidNY

National Provider Directory

National Provider Directory

Locations

1390 Pennsylvania Ave
Brooklyn, NY 11239
Phone (718) 642-1100

NPI Registry JSON

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1609171370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112392103",
            "telephone_number": "718-642-9855",
            "fax_number": "718-599-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112392103",
            "telephone_number": "718-642-9855",
            "fax_number": "718-599-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NABIL AND REBECCA G RAOOF, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "RAOOF",
        "authorized_official_first_name": "NABIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-642-9855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "127162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00237054",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00237518",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.