Provider Demographics
NPI:1003619537
Name:RABAS, MACKENZIE SARAH (MD)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:SARAH
Last Name:RABAS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 N HUMBOLDT AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2141
Mailing Address - Country:US
Mailing Address - Phone:262-751-5129
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE L LEVY PL # 1149
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6504
Practice Address - Country:US
Practice Address - Phone:212-241-6639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program