Provider Demographics
NPI:1942347992
Name:RABINOWITCH, BONNIE L (MD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:L
Last Name:RABINOWITCH
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 1:2100 KEYSTONE AVE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-1129
Mailing Address - Country:US
Mailing Address - Phone:610-622-8900
Mailing Address - Fax:610-626-8904
Practice Address - Street 1:2100 KEYSTONE AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1129
Practice Address - Country:US
Practice Address - Phone:610-622-8900
Practice Address - Fax:610-626-8904
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046000L207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001417603Medicaid
PA744517Medicare ID - Type Unspecified
PAF56771Medicare UPIN