Provider Demographics
NPI:1114045044
Name:RABINOWITZ, EVAN M (MAC, LAC)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:M
Last Name:RABINOWITZ
Suffix:
Gender:M
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 17TH ST NW STE 1020
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-2623
Mailing Address - Country:US
Mailing Address - Phone:202-822-4664
Mailing Address - Fax:
Practice Address - Street 1:910 17TH ST NW STE 1020
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-2623
Practice Address - Country:US
Practice Address - Phone:202-822-4664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC30074171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist