Provider Demographics
NPI:1700168614
Name:NEW YORK HOME KIDNEY AND MEDICINE CARE PLLC
Entity type:Organization
Organization Name:NEW YORK HOME KIDNEY AND MEDICINE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHMIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RABENOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-282-8085
Mailing Address - Street 1:541 E 20TH ST
Mailing Address - Street 2:#13E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7612
Mailing Address - Country:US
Mailing Address - Phone:917-282-8085
Mailing Address - Fax:
Practice Address - Street 1:541 E 20TH ST
Practice Address - Street 2:#13E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7612
Practice Address - Country:US
Practice Address - Phone:917-282-8085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208912207RN0300X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty