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NPI Code Detail

MEDICARE: ILONA RABINOVICH FNP

MEDICARE: ILONA RABINOVICH FNP
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
1163W00000XRegistered Nurse706816-1NY
2363LF0000XFamily Nurse Practitioner346390NY

General Provider Information

NPI Number : 1114539368
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILONA RABINOVICH FNP
Provider Business Mailing Address
First Line : 6 ARBOR CT
Second Line :
City : MANALAPAN
State : NJ
Zip : 07726-2859
Country : US
Telephone Number : 917-972-4170
Fax Number :
Provider Business Practice Location Address
First Line : 2043 RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-3936
Country : US
Telephone Number : 718-710-4906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2020
Last Update Date : 07/23/2024

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