Healthcare Provider Details

I. General information

NPI: 1861491763
Provider Name (Legal Business Name): RAHMIN ARI RABENOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 09/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E 34TH ST
NEW YORK NY
10016-4974
US

IV. Provider business mailing address

317 E 34TH ST
NEW YORK NY
10016-4974
US

V. Phone/Fax

Practice location:
  • Phone: 212-726-7432
  • Fax: 212-981-7270
Mailing address:
  • Phone: 212-726-7432
  • Fax: 212-981-7270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number208912
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: