Provider Demographics
NPI:1073865515
Name:RABEN, HUBERTUS (MA, LP)
Entity Type:Individual
Prefix:MR
First Name:HUBERTUS
Middle Name:
Last Name:RABEN
Suffix:
Gender:M
Credentials:MA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 S ELLIOTT PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-1207
Mailing Address - Country:US
Mailing Address - Phone:917-268-4166
Mailing Address - Fax:
Practice Address - Street 1:17 S ELLIOTT PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1207
Practice Address - Country:US
Practice Address - Phone:917-268-4166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2019-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000350-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst