Basic Information
| Provider Information | |||||||||
| NPI: | 1548249501 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELLA RATTA | ||||||||
| FirstName: | RALPH | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 STATION PLAZA NORTH | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166633822 | ||||||||
| FaxNumber: | 5166634740 | ||||||||
| Practice Location | |||||||||
| Address1: | 222 STATION PLAZA NORTH | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166632051 | ||||||||
| FaxNumber: | 5166634740 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2006 | ||||||||
| LastUpdateDate: | 03/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | NYS170187 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0062964 | 01 | GHI | OTHER | 5911062 | 01 | AETNA | OTHER | 431683N | 01 | CIGNA | OTHER | 1307780 | 01 | FIRSTHEALTH | OTHER | 759931 | 01 | UNITED HEALTHCARE | OTHER | 316 | 01 | VYTRA | OTHER | AP798 | 01 | OXFORD | OTHER | 110033182 | 01 | RAILROAD MEDICARE | OTHER | 0146547 | 05 | NY | MEDICAID | 06F171 | 01 | BCBS | OTHER |