Babak Mardekheh Rafiei, RPA-C
Individual provider Active NPI Physician Assistant · Brooklyn, NM
NPI 1720257223 · NPPES record last updated Feb 28, 2008
Key facts
- NPI
- 1720257223
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 011285 (NY)
- Practice address
- 1149-55 Myrtle Avenue
Brooklyn, NM 11206 - Phone
- (718) 574-1928
- Fax
- (718) 919-2374
- NPI assigned
- Feb 28, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011285 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Start Treatment & Recovery Centers Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 011285 | NY | Yes |
Addresses
Primary practice location
1149-55 Myrtle Avenue
Brooklyn, NM 11206
Mailing address
22 Chapel St
Brooklyn, NY 11201-1903
Phone (718) 260-2962
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 011285 | Other | NY | NEW YORK STATE |
Other providers in Brooklyn, NM
All providers in Brooklyn, NM · Physician Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.