Provider Demographics
NPI:1144314360
Name:RABINOWITZ, SIMON S (MD)
Entity type:Individual
Prefix:
First Name:SIMON
Middle Name:S
Last Name:RABINOWITZ
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 1:445 LENOX RD
Mailing Address - Street 2:DEPT OF PEDIATRICS, BOX 49
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2098
Mailing Address - Country:US
Mailing Address - Phone:718-270-1647
Mailing Address - Fax:718-270-1985
Practice Address - Street 1:445 LENOX RD
Practice Address - Street 2:DEPT OF PEDIATRICS, BOX 49
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2098
Practice Address - Country:US
Practice Address - Phone:718-270-1647
Practice Address - Fax:718-270-1985
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY161072208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SR089D1410Medicare ID - Type Unspecified
A64662Medicare UPIN