Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 198242 | NY |
NPI | 1235195769 |
---|---|
Provider Name | Dr. Michael Rabice |
First Address | Bowmansville, NY 14026-2008 |
Second Address | Bowmansville, NY 14026-1035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01716774 | (05) | NY |