Provider Demographics
NPI:1528348562
Name:RAHAV, MIRIAM (MD)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:RAHAV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W 15TH ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6412
Mailing Address - Country:US
Mailing Address - Phone:212-717-1118
Mailing Address - Fax:212-717-1121
Practice Address - Street 1:205 W 15TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6412
Practice Address - Country:US
Practice Address - Phone:212-717-1118
Practice Address - Fax:212-717-1121
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY264399207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine