Provider Demographics
NPI:1093949737
Name:TRUCHIL, RACHAEL SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:SUSAN
Last Name:TRUCHIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 N. 39TH STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-9990
Mailing Address - Fax:
Practice Address - Street 1:51 N. 39TH STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-9990
Practice Address - Fax:570-271-6141
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445458207R00000X
PAMT194905390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1027140420001Medicaid
PATR240745Medicare PIN