Provider Demographics
NPI:1659333094
Name:RABINOVICH, ANNA (NP)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:RABINOVICH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 PENINSULA BLVD
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3155
Mailing Address - Country:US
Mailing Address - Phone:516-599-6529
Mailing Address - Fax:
Practice Address - Street 1:400 GARDEN CITY PLZ
Practice Address - Street 2:SUITE 111
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3322
Practice Address - Country:US
Practice Address - Phone:516-739-3030
Practice Address - Fax:516-739-3044
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304212363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health