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NPI Code Detail

MEDICARE: ALEXANDER CHRISTIAN RABIDEAU PA

MEDICARE: ALEXANDER CHRISTIAN RABIDEAU PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant030221NY

General Provider Information

NPI Number : 1205610060
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDER CHRISTIAN RABIDEAU PA
Provider Business Mailing Address
First Line : 128 BOYNTON AVE
Second Line :
City : PLATTSBURGH
State : NY
Zip : 12901-1237
Country : US
Telephone Number : 518-324-3399
Fax Number :
Provider Business Practice Location Address
First Line : 128 BOYNTON AVE
Second Line :
City : PLATTSBURGH
State : NY
Zip : 12901-1237
Country : US
Telephone Number : 518-324-3399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2023
Last Update Date : 08/22/2023

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Directions to “ ALEXANDER CHRISTIAN RABIDEAU PA” Practice Location

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