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Contact Information

RAPHAEL BOLLAG, MD
301 E MAIN ST
BAY SHORE, NY11706-8408
 Phone: 631-968-3000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for RAPHAEL BOLLAG · (Male)

NPI # 1629463708
Status Active
Credentials MD
Entity Individual
Enumeration date 04/05/2015
Last updated 07/20/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 295389
Hospital affiliation(s)
  • SOUTHSIDE HOSPITAL - (Acute Care)
    301 EAST MAIN STREET
    BAY SHORE, NY 11706
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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