Provider Demographics
NPI:1538312004
Name:FOX-RABINOVICH, LOLA (LAC)
Entity Type:Individual
Prefix:
First Name:LOLA
Middle Name:
Last Name:FOX-RABINOVICH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 GROSVENOR PL APT 1601
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4643
Mailing Address - Country:US
Mailing Address - Phone:301-404-1455
Mailing Address - Fax:301-530-1741
Practice Address - Street 1:50 W EDMONSTON DR
Practice Address - Street 2:SUITE 505
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1228
Practice Address - Country:US
Practice Address - Phone:240-403-0885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01679171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist