| Tina Susanne Rakitt, MD | |
| 279 3rd Ave, Suite 101, Long Branch, NJ 07740-6211 | |
| (732) 923-6080 | |
| (732) 923-6083 | 
| Full Name | Tina Susanne Rakitt | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics - Pediatric Gastroenterology | 
| Location | 279 3rd Ave, Long Branch, New Jersey | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1124255534 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2080P0206X | Pediatrics - Pediatric Gastroenterology | 25MA08567000 (New Jersey) | Primary | 
| Entity Name | Maimonides Faculty Practice Plan | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1053344846 PECOS PAC ID: 7012808348 Enrollment ID: O20040324000597 | 
| Entity Name | Mmc Pediatrics Faculty Practice | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1285648154 PECOS PAC ID: 0143406918 Enrollment ID: O20110511000496 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Tina Susanne Rakitt, MD Po Box 8000, Dept 596, Buffalo, NY 14267-0002 Ph: (866) 295-0041 | Tina Susanne Rakitt, MD 279 3rd Ave, Suite 101, Long Branch, NJ 07740-6211 Ph: (732) 923-6080 | 
| Dr. Kirby Douglas Rekedal, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 2nd Ave, Long Branch, NJ 07740 Phone: 732-923-6860 | |
| Amit C Misra, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Second Avenue, Long Branch, NJ 07740 Phone: 732-923-8600 | |
| Dr. Richard J Degroote Ii, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 300 2nd Ave, Long Branch, NJ 07740 Phone: 732-923-7100 Fax: 732-923-7104 | |
| Imtiaz Ahmed, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 2nd Ave, Long Branch, NJ 07740 Phone: 610-400-5782 | |
| Dr. Danielle Denise Amona, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 2nd Ave, Long Branch, NJ 07740 Phone: 732-222-5200 | |
| Dr. Thomas Habib, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 255 3rd Ave, Long Branch, NJ 07740 Phone: 732-222-7006 |