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General NPI Number Information
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NPI Number | 1518019900
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Entity Type | Individual
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Provider Name | WILFRID NOEL RABY PH.D., M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 175 CEDAR LN SUITE 7
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City | TEANECK
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State | NJ
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Zip | 07666-4315
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Country | US
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Telephone | 201-801-0052
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Fax | 212-568-3832
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Provider Business Mailing Address
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Address Line | 4525 HENRY HUDSON PKWY APT 304
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City | BRONX
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State | NY
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Zip | 10471-3808
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Country | US
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Telephone | 718-884-1315
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Fax | 212-568-3832
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MA66123
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License Number State | NJ
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