Provider Demographics
NPI:1184657512
Name:RABINOWITZ-RODRIGUEZ CORPORATION
Entity Type:Organization
Organization Name:RABINOWITZ-RODRIGUEZ CORPORATION
Other - Org Name:MADISON AVENUE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-ZIERER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-291-9797
Mailing Address - Street 1:22 MADISON AVENUE
Mailing Address - Street 2:SUITE 3 3RD FLOOR
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-291-9797
Mailing Address - Fax:201-291-9798
Practice Address - Street 1:22 MADISON AVE
Practice Address - Street 2:SUITE 3 3RD FLOOR
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-291-9797
Practice Address - Fax:201-291-9798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0002224Medicaid