Provider Demographics
NPI:1326176678
Name:SAMIR RABY, MD PC
Entity Type:Organization
Organization Name:SAMIR RABY, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:RABY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-599-3430
Mailing Address - Street 1:182 EARLE AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2627
Mailing Address - Country:US
Mailing Address - Phone:516-599-3430
Mailing Address - Fax:516-593-1391
Practice Address - Street 1:182 EARLE AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-2627
Practice Address - Country:US
Practice Address - Phone:516-599-3430
Practice Address - Fax:516-593-1391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty