Provider Demographics
NPI:1588761092
Name:TAWIL, ALRABI N (MD)
Entity type:Individual
Prefix:
First Name:ALRABI
Middle Name:N
Last Name:TAWIL
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:PO BOX 278984
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14627-8984
Mailing Address - Country:US
Mailing Address - Phone:585-275-6372
Mailing Address - Fax:585-273-1255
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-6372
Practice Address - Fax:585-273-1255
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196443207ZN0500X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01573239Medicaid
NY01573239Medicaid
NY11146YMedicare PIN