Healthcare Provider Details

I. General information

NPI: 1457835670
Provider Name (Legal Business Name): GABRIELLE RABINOWITZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4117 AVENUE U
BROOKLYN NY
11234-5119
US

IV. Provider business mailing address

1360 OCEAN PKWY APT 5H
BROOKLYN NY
11230-5626
US

V. Phone/Fax

Practice location:
  • Phone: 917-304-1328
  • Fax:
Mailing address:
  • Phone: 917-304-1328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. GABRIELLE A RABINOWITZ
Title or Position: PROGRAM DIRECTOR
Credential: M.S.ED.
Phone: 917-304-1328