Provider Demographics
NPI:1619028685
Name:RAFFEL, JOANNE K (CRNFA)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:K
Last Name:RAFFEL
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Gender:F
Credentials:CRNFA
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Mailing Address - Street 1:250 PATCHOGUE YAPHANK RD
Mailing Address - Street 2:SUITE #7
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4800
Mailing Address - Country:US
Mailing Address - Phone:631-475-1013
Mailing Address - Fax:631-475-1092
Practice Address - Street 1:250 PATCHOGUE YAPHANK RD
Practice Address - Street 2:SUITE #7
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4800
Practice Address - Country:US
Practice Address - Phone:631-475-1013
Practice Address - Fax:631-475-1092
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-10-16
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Provider Licenses
StateLicense IDTaxonomies
NY253583-1364SP2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperative
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW04331Medicare PIN