Basic Information
| Provider Information | |||||||||
| NPI: | 1306937859 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RATHBONE | ||||||||
| FirstName: | ISABEL | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SERVICI | ||||||||
| OtherFirstName: | ISABEL | ||||||||
| OtherMiddleName: | GISELDA | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 75 PECK ROAD | ||||||||
| Address2: | |||||||||
| City: | BETHANY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033939313 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | VA CONNECTICUT/116A | ||||||||
| Address2: | 950 CAMPBELL AVENUE | ||||||||
| City: | WEST HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2039325711 | ||||||||
| FaxNumber: | 2039374791 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084A0401X | 24024 | CT | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine |
No ID Information.