Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | CQP33537 | NY |
NPI | 1487868550 |
---|---|
Provider Name | Dr. Mark Rabin |
First Address | Cheshire, CT 06410-2953 |
Second Address | Stratford, CT 06615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |