Provider Demographics
NPI:1073896650
Name:CRAIG, RABIAH SALIHAH
Entity Type:Individual
Prefix:
First Name:RABIAH
Middle Name:SALIHAH
Last Name:CRAIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7543 PLUM HOLLOW CIR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-3624
Mailing Address - Country:US
Mailing Address - Phone:315-450-6038
Mailing Address - Fax:
Practice Address - Street 1:7543 PLUM HOLLOW CIR
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-3624
Practice Address - Country:US
Practice Address - Phone:315-450-6038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301337-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse