Provider Demographics
NPI:1316984990
Name:RABKIN, DMITRY J (MD)
Entity type:Individual
Prefix:
First Name:DMITRY
Middle Name:J
Last Name:RABKIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL INTERVENTIONAL RADIOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-525-8085
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL INTERVENTIONAL RADIOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-525-8085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2012-09-24
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Provider Licenses
StateLicense IDTaxonomies
MA1597312085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA3069702Medicare PIN