Provider Demographics
NPI:1699891416
Name:DIMITRY RABKIN, M.D., P.C.
Entity type:Organization
Organization Name:DIMITRY RABKIN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIMITRY
Authorized Official - Middle Name:
Authorized Official - Last Name:RABKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-339-6800
Mailing Address - Street 1:202 QUENTIN RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1475
Mailing Address - Country:US
Mailing Address - Phone:718-339-6800
Mailing Address - Fax:718-375-4187
Practice Address - Street 1:202 QUENTIN RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1475
Practice Address - Country:US
Practice Address - Phone:718-339-6800
Practice Address - Fax:718-375-4187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187443207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY49K571Medicare PIN
NYG04172Medicare UPIN
NY03398AMedicare PIN
NJ112310Medicare PIN
NJ024434WSUMedicare PIN
NYWBW811Medicare PIN
NY03398GMedicare PIN