Provider Demographics
NPI:1013209451
Name:REICH, RACHEL (LAC, LMT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:REICH
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 564
Mailing Address - Street 2:
Mailing Address - City:JAMESPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11947-0564
Mailing Address - Country:US
Mailing Address - Phone:631-629-6636
Mailing Address - Fax:
Practice Address - Street 1:32845 MAIN RD STE G
Practice Address - Street 2:
Practice Address - City:CUTCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11935-1691
Practice Address - Country:US
Practice Address - Phone:631-629-6636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
NY002921171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty