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NPI Code Detail

MEDICARE: JACQUELINE RABBENA

MEDICARE: JACQUELINE RABBENA
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1336721711
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE RABBENA
Provider Business Mailing Address
First Line : 36 GUNTON PL
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-1782
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1854 HYLAN BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-2119
Country : US
Telephone Number : 212-432-6613
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2021
Last Update Date : 04/25/2021

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Directions to “ JACQUELINE RABBENA ” Practice Location

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