Basic Information
| Provider Information | |||||||||
| NPI: | 1043429475 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RATHBONE | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | RODION | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | RATHBONE | ||||||||
| OtherFirstName: | RODION | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 75 PECK RD | ||||||||
| Address2: | |||||||||
| City: | BETHANY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065243343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033939313 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 20 YORK ST | ||||||||
| Address2: | YALE-NEW HAVEN HOSPITAL | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065048900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2036882439 | ||||||||
| FaxNumber: | 2036885103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 207ZP0105X | 024868 | CT | Y | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology/Laboratory Medicine |
No ID Information.