Provider Demographics
NPI:1689660854
Name:RABINOVICH, FAYE (DO)
Entity Type:Individual
Prefix:DR
First Name:FAYE
Middle Name:
Last Name:RABINOVICH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9945 67TH RD STE 103
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3037
Mailing Address - Country:US
Mailing Address - Phone:718-275-2698
Mailing Address - Fax:718-275-2944
Practice Address - Street 1:9732 63RD RD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1639
Practice Address - Country:US
Practice Address - Phone:718-275-2698
Practice Address - Fax:646-680-0646
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219631207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01811930Medicaid
NY01811930Medicaid
NY1689660854Medicare UPIN