Provider Demographics
NPI:1598282204
Name:TABAKU, ARBEN (RN)
Entity Type:Individual
Prefix:
First Name:ARBEN
Middle Name:
Last Name:TABAKU
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12211 82ND RD
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1432
Mailing Address - Country:US
Mailing Address - Phone:917-670-6107
Mailing Address - Fax:718-459-3637
Practice Address - Street 1:6817 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4237
Practice Address - Country:US
Practice Address - Phone:718-830-4970
Practice Address - Fax:718-459-3637
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY624765163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY624765OtherREGISTER PROFESSIONAL NURSE