Provider Demographics
NPI:1821549783
Name:IBRAHIM Y RABADI MD PC
Entity Type:Organization
Organization Name:IBRAHIM Y RABADI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:Y
Authorized Official - Last Name:RABADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-943-3844
Mailing Address - Street 1:35 S JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-2109
Mailing Address - Country:US
Mailing Address - Phone:518-943-3844
Mailing Address - Fax:
Practice Address - Street 1:35 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-2109
Practice Address - Country:US
Practice Address - Phone:518-943-3844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty