Basic Information
| Provider Information | |||||||||
| NPI: | 1538183462 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RATNER | ||||||||
| FirstName: | SANFORD | ||||||||
| MiddleName: | BRUCE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2800 MARCUS AVE | ||||||||
| Address2: | |||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110421113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166226000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 20615 HILLSIDE AVE | ||||||||
| Address2: | |||||||||
| City: | QUEENS VILLAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114271709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187760101 | ||||||||
| FaxNumber: | 7187764841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 09/25/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 140102 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 510346 | 01 | NY | UNITED HEALTH CARE | OTHER | P604465 | 01 | NY | OXFORD | OTHER | 0C294P | 01 | NY | H.I.P. | OTHER | 4061451 | 01 | NY | AETNA | OTHER | 421447N | 01 | NY | CIGNA | OTHER | 510346 | 01 | NY | U.S. HEALTHCARE | OTHER | 68A641 | 01 | NY | BLUE CROSS | OTHER | 89357 | 01 | NY | G.H.I. | OTHER |