Provider Demographics
NPI:1124067301
Name:RABATIN, JOSEPH STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:STEPHEN
Last Name:RABATIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BREWSTER STREET
Mailing Address - Street 2:WOOD BLDG 516
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4400
Mailing Address - Country:US
Mailing Address - Phone:401-729-3481
Mailing Address - Fax:401-729-2721
Practice Address - Street 1:111 BREWSTER STREET
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4400
Practice Address - Country:US
Practice Address - Phone:401-729-2258
Practice Address - Fax:401-729-2494
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185590207R00000X
RIMD12231207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7058924Medicaid
RI007058924OtherMEDICARE PTAN
NY2161S1Medicare ID - Type Unspecified
RI007058924OtherMEDICARE PTAN