Provider Demographics
NPI:1619983715
Name:RABINOWITZ, ROBERT PHILLIP (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PHILLIP
Last Name:RABINOWITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 LAKEHURST RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6345
Mailing Address - Country:US
Mailing Address - Phone:732-341-5403
Mailing Address - Fax:732-505-0862
Practice Address - Street 1:462 LAKEHURST RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6345
Practice Address - Country:US
Practice Address - Phone:732-341-5403
Practice Address - Fax:732-505-0862
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05659300207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5012708Medicaid
NJ805977Medicare ID - Type Unspecified
NJ5012708Medicaid