Basic Information
| Provider Information | |||||||||
| NPI: | 1457506388 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RABBI | ||||||||
| FirstName: | JAMAL | ||||||||
| MiddleName: | FAZAL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 TRADEPARK DR | ||||||||
| Address2: | STE B | ||||||||
| City: | SOMERSET | ||||||||
| State: | KY | ||||||||
| PostalCode: | 425033454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064510300 | ||||||||
| FaxNumber: | 6064510595 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 TRADEPARK DR STE B | ||||||||
| Address2: | |||||||||
| City: | SOMERSET | ||||||||
| State: | KY | ||||||||
| PostalCode: | 425033454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064510300 | ||||||||
| FaxNumber: | 6064510595 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2008 | ||||||||
| LastUpdateDate: | 04/25/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | 2014030826 | MO | N | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 89138 | OH | N | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | MD446740 | PA | N | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 51904 | KY | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.