Provider Demographics
NPI:1669610929
Name:NABER, RENE (LMT)
Entity type:Individual
Prefix:MS
First Name:RENE
Middle Name:
Last Name:NABER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2830
Mailing Address - Country:US
Mailing Address - Phone:631-704-4761
Mailing Address - Fax:
Practice Address - Street 1:157 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2830
Practice Address - Country:US
Practice Address - Phone:631-704-4761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-25
Last Update Date:2021-07-28
Deactivation Date:2010-12-13
Deactivation Code:
Reactivation Date:2012-12-13
Provider Licenses
StateLicense IDTaxonomies
NY004966171100000X
NY27008500225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist