Provider Demographics
NPI:1205800760
Name:RABER, JULIA (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:RABER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WHITEWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576
Mailing Address - Country:US
Mailing Address - Phone:516-216-5550
Mailing Address - Fax:516-358-2340
Practice Address - Street 1:1300 UNION TPK
Practice Address - Street 2:STE. 107
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:516-216-5550
Practice Address - Fax:516-358-2340
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYH55833174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJR0527D410Medicare ID - Type Unspecified
NYH55833Medicare UPIN