Provider Demographics
NPI:1811187123
Name:RABINOWITZ, LISA (LPT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:RABINOWITZ
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11204 HUNTING HORN LN
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-4506
Mailing Address - Country:US
Mailing Address - Phone:703-716-3022
Mailing Address - Fax:
Practice Address - Street 1:9229 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2504
Practice Address - Country:US
Practice Address - Phone:703-277-6611
Practice Address - Fax:703-383-0206
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005233225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist