Provider Demographics
NPI:1144252669
Name:RAFFA, HACENE (MD)
Entity type:Individual
Prefix:
First Name:HACENE
Middle Name:
Last Name:RAFFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4-473 MASSENET
Mailing Address - Street 2:
Mailing Address - City:CHICOUTIMI
Mailing Address - State:QC
Mailing Address - Zip Code:G7H2W9
Mailing Address - Country:CA
Mailing Address - Phone:418-549-5474
Mailing Address - Fax:
Practice Address - Street 1:CENTRE SANTE SS CHICOUTIMI
Practice Address - Street 2:150 PINEL/QUEBEC
Practice Address - City:CHICOUTIMI,QC
Practice Address - State:QC
Practice Address - Zip Code:G7G3W4
Practice Address - Country:CA
Practice Address - Phone:418-549-5474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA454602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry