Provider Demographics
NPI:1831292887
Name:RABKINA, ANNA (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:RABKINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 526
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01903
Mailing Address - Country:US
Mailing Address - Phone:781-596-2502
Mailing Address - Fax:781-596-3966
Practice Address - Street 1:269 UNION ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901
Practice Address - Country:US
Practice Address - Phone:781-596-3500
Practice Address - Fax:781-596-3201
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215382207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1301853Medicaid
MA1301853Medicaid
A34610Medicare ID - Type Unspecified