Provider Demographics
NPI:1396893301
Name:RABINOWITZ, SHAUL (PHD)
Entity type:Individual
Prefix:DR
First Name:SHAUL
Middle Name:
Last Name:RABINOWITZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 NORTH MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3434
Mailing Address - Country:US
Mailing Address - Phone:516-868-8401
Mailing Address - Fax:516-868-8539
Practice Address - Street 1:124 NORTH MERRICK AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3434
Practice Address - Country:US
Practice Address - Phone:516-868-8401
Practice Address - Fax:516-868-8539
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009010103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV47211Medicare ID - Type Unspecified