Provider Demographics
NPI:1538183462
Name:RATNER, SANFORD BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:BRUCE
Last Name:RATNER
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 1:2800 MARCUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1113
Mailing Address - Country:US
Mailing Address - Phone:516-622-6000
Mailing Address - Fax:
Practice Address - Street 1:20615 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-1709
Practice Address - Country:US
Practice Address - Phone:718-776-0101
Practice Address - Fax:718-776-4841
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140102207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY510346OtherUNITED HEALTH CARE
NYP604465OtherOXFORD
NY0C294POtherH.I.P.
NY4061451OtherAETNA
NY421447NOtherCIGNA
NY510346OtherU.S. HEALTHCARE
NY68A641OtherBLUE CROSS
NY89357OtherG.H.I.
NY89357OtherG.H.I.
89357Medicare ID - Type Unspecified