Provider Demographics
NPI:1922111210
Name:RABINOWITZ, MARC S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:S
Last Name:RABINOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 STREET RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-4728
Mailing Address - Country:US
Mailing Address - Phone:215-357-2666
Mailing Address - Fax:215-357-2677
Practice Address - Street 1:965 STREET RD
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-4728
Practice Address - Country:US
Practice Address - Phone:215-357-2666
Practice Address - Fax:215-357-2677
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039949E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
543913OtherAETNA
0468568000OtherBS
0468568000OtherBS
638251KC0Medicare ID - Type Unspecified