Basic Information
Provider Information
NPI: 1720280621
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RABIN BLAIR
FirstName: LAUREN
MiddleName: KAY
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: RABIN
OtherFirstName: LAUREN
OtherMiddleName: KAY
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 2101 E JEFFERSON ST
Address2: KAISER PERMANENTE MEDICARE ENROLLMENT
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018162424
FaxNumber:  
Practice Location
Address1: 4920 CAMPBELL BLVD
Address2: DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
City: NOTTINGHAM
State: MD
PostalCode: 212365916
CountryCode: US
TelephoneNumber: 4109337684
FaxNumber: 4109337601
Other Information
ProviderEnumerationDate: 06/03/2007
LastUpdateDate: 06/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XD0072672MDY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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