MEDICARE: DR. JOSE J RABELO M.D.

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	152488	NY

General Provider Information

NPI Number	:	1578617734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE J RABELO M.D.

Provider Business Mailing Address
First Line	:	158 W 27TH ST
Second Line	:	11TH FLOOR SOUTH
City	:	NEW YORK
State	:	NY
Zip	:	10001-6216
Country	:	US
Telephone Number	:	212-563-2497
Fax Number	:	212-563-0605

Provider Business Practice Location Address
First Line	:	97 E 4TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-9002
Country	:	US
Telephone Number	:	212-979-3200
Fax Number	:	212-979-3227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	07/09/2007

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