Provider Demographics
NPI:1174722847
Name:RRL MEDICAL PRACTICE P.C.
Entity type:Organization
Organization Name:RRL MEDICAL PRACTICE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIFAI-LOEWENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-767-0603
Mailing Address - Street 1:60 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-1013
Mailing Address - Country:US
Mailing Address - Phone:914-767-0603
Mailing Address - Fax:914-767-9202
Practice Address - Street 1:60 CHERRY ST
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-1013
Practice Address - Country:US
Practice Address - Phone:914-767-0603
Practice Address - Fax:914-767-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177154207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE80608Medicare UPIN
51C341Medicare PIN