Provider Demographics
NPI:1902168974
Name:RABSON, MARTHA TIRESINA (TEACHER)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:TIRESINA
Last Name:RABSON
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BIRCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-2602
Mailing Address - Country:US
Mailing Address - Phone:845-528-2201
Mailing Address - Fax:
Practice Address - Street 1:10 BIRCH HILL RD
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579-2602
Practice Address - Country:US
Practice Address - Phone:845-528-2201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist