Provider Demographics
NPI:1821478215
Name:EDEN, RINA (DO)
Entity type:Individual
Prefix:DR
First Name:RINA
Middle Name:
Last Name:EDEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RINA
Other - Middle Name:
Other - Last Name:KOENKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:UNIT 6180 BOX 245
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09604-6180
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AREA 1 BUILDING 121
Practice Address - Street 2:
Practice Address - City:AVIANO AIR BASE
Practice Address - State:PN
Practice Address - Zip Code:09603
Practice Address - Country:IT
Practice Address - Phone:314-632-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2025-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A18616207ZB0001X, 207ZP0102X
HI1781207ZP0102X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice