Individual ProviderRaffat FazalCounselorBehavioral Health & Social Service ProvidersPractice Address2291 Victory Blvd, Staten Island, NY 10314-6625(917) 584-6507PECOS EnrollmentBased on the most recent information from CMS, provider Raffat Fazal does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 1:08 PM.Profile DetailsProvider ID1750827788Provider TypeIndividualFull NameFazal, RaffatTitleMrs.GenderFemaleSole ProprietorYesEnumeration Date1/14/2017Last Updated1/14/2017Contact InformationPractice LocationPractice Address2291 Victory Blvd, Staten Island, NY 10314-6625Phone(917) 584-6507FaxUnlisted FaxMailing LocationMailing Address482 Barlow Ave, Staten Island, NY 10308-1205Phone(917) 584-6507FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense003079New York