Provider Demographics
NPI:1538120845
Name:RABNER, DEBORAH (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:RABNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:DEBORAH RABNER MD LLC
Mailing Address - Street 2:MSC#894 PO BOX 830639
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0639
Mailing Address - Country:US
Mailing Address - Phone:561-232-6578
Mailing Address - Fax:973-575-1616
Practice Address - Street 1:1129 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7127
Practice Address - Country:US
Practice Address - Phone:973-575-6880
Practice Address - Fax:973-575-1616
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA54796207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6608906Medicaid
NJ717133Medicare PIN