Active NPI
Bijan Rabenou, PH. D.
- Psychologist
- Brooklyn, NY
National Provider Identifier
1194758466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 007089-1
- Practice address
- 50 Court St
Brooklyn, NY 11201-4859 - Phone
- (718) 855-7707
- Fax
- (718) 855-7717
- NPI assigned
- Jul 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 007089-1 | NY | Primary |
Addresses
Primary practice location
50 Court St
Brooklyn, NY 11201-4859
Mailing address
8421 122ND St
Kew Gardens, NY 11415-3233
Phone (347) 651-5130
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007089 | NY | MD | Occupational Therapy Assistant |
| 007089-1 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heartshare Wellness, LTD. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Public Health or Welfare Agency
- Brooklyn, NY
- NPI 1487895371
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194758466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8421 122ND ST",
"city": "KEW GARDENS",
"state": "NY",
"postal_code": "114153233",
"telephone_number": "347-651-5130",
"fax_number": "718-847-3808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 COURT ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112014859",
"telephone_number": "718-855-7707",
"fax_number": "718-855-7717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RABENOU",
"first_name": "BIJAN",
"name_prefix": "Dr.",
"credential": "PH. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "007089-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.