Provider Demographics
NPI:1457835670
Name:GABRIELLE RABINOWITZ LLC
Entity Type:Organization
Organization Name:GABRIELLE RABINOWITZ LLC
Other - Org Name:PRIMETIME PLAY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RABINOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:917-304-1328
Mailing Address - Street 1:1360 OCEAN PKWY APT 5H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5626
Mailing Address - Country:US
Mailing Address - Phone:917-304-1328
Mailing Address - Fax:
Practice Address - Street 1:4117 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5119
Practice Address - Country:US
Practice Address - Phone:917-304-1328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========Medicaid