Provider Demographics
NPI:1003177809
Name:KURIAN, RACHEL JOY (MASPED)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:JOY
Last Name:KURIAN
Suffix:
Gender:F
Credentials:MASPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 MAPLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752-2523
Mailing Address - Country:US
Mailing Address - Phone:516-532-8240
Mailing Address - Fax:
Practice Address - Street 1:354 MAPLEWOOD ST
Practice Address - Street 2:
Practice Address - City:ISLIP TERRACE
Practice Address - State:NY
Practice Address - Zip Code:11752-2523
Practice Address - Country:US
Practice Address - Phone:516-532-8240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1858013171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor