Provider Demographics
NPI:1235504606
Name:RABINOVICH, YEVGENIYA
Entity Type:Individual
Prefix:
First Name:YEVGENIYA
Middle Name:
Last Name:RABINOVICH
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 1:919 WESTFALL RD BUILDING C BOX 673
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-880-4613
Mailing Address - Fax:
Practice Address - Street 1:919 WESTFALL RD BUILDING C
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-3327
Practice Address - Country:US
Practice Address - Phone:585-880-4613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-10
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY693350163W00000X
NY3451902084N0400X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology