MEDICARE: MRS. MARCY MR RABINOWITZ MA, RD

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
1	133V00000X	Registered Dietitian	487002	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1997821	OTHER	NJ	UNITED HEALTHCARE
2	2313299	OTHER	NJ	AETNA HEALTHCARE
3	P888914	OTHER	NJ	OXFORD HEALTH PLANS

General Provider Information

NPI Number	:	1568505576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARCY MR RABINOWITZ MA, RD

Provider Business Mailing Address
First Line	:	50 CROFT PL
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-6508
Country	:	US
Telephone Number	:	267-388-9727
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 ROUTE #70 EAST
Second Line	:	SUITE #401
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034
Country	:	US
Telephone Number	:	856-354-9100
Fax Number	:	856-428-3304

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	11/11/2015

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