Provider Demographics
NPI:1922192343
Name:RABIN, SHELDON (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:
Last Name:RABIN
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 1:59 WENSLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11020-1835
Mailing Address - Country:US
Mailing Address - Phone:718-539-4010
Mailing Address - Fax:718-321-9587
Practice Address - Street 1:41-61 KISSENA BLVD.
Practice Address - Street 2:ENTRANCE ON BARCLAY AVE
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-539-4010
Practice Address - Fax:718-321-9587
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112082207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00202520Medicaid
NYW39841Medicare PIN
NY00202520Medicaid
NY10457Medicare ID - Type Unspecified