Provider Demographics
NPI:1164462206
Name:RABINOWITZ, MARVIN S (MD)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:S
Last Name:RABINOWITZ
Suffix:
Gender:M
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:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:CLAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13322-0275
Mailing Address - Country:US
Mailing Address - Phone:315-839-5575
Mailing Address - Fax:315-839-5587
Practice Address - Street 1:239 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-2321
Practice Address - Country:US
Practice Address - Phone:315-866-0538
Practice Address - Fax:707-202-2731
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166250-1207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01395775Medicaid
DCBR1351484OtherDEA
56244BMedicare ID - Type Unspecified
NY01395775Medicaid