Provider Demographics
NPI:1962735589
Name:ALEXANDER RABINOVICH MEDICAL PC
Entity type:Organization
Organization Name:ALEXANDER RABINOVICH MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:RABINOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-815-9094
Mailing Address - Street 1:2940 OCEAN PKWY
Mailing Address - Street 2:APT. 15T
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8250
Mailing Address - Country:US
Mailing Address - Phone:347-374-3758
Mailing Address - Fax:
Practice Address - Street 1:1630 E 15TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1147
Practice Address - Country:US
Practice Address - Phone:718-375-6933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252107207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty