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Individual

DR. LEROY ELAZAR RABBANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(212) 342-3616
Mailing address
630 W 168TH ST # 4, VC 12TH FLOOR, SUITE 208, NEW YORK, NY 10032-3725

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
162807
NY
207RI0011X
Interventional Cardiology Physician
Primary
162807
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01440853
NY
Enumeration date
11/01/2006
Last updated
05/29/2015
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