Provider Demographics
NPI:1114327863
Name:REICHART, RACHEL MARIA (MS, ATC, PES)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:MARIA
Last Name:REICHART
Suffix:
Gender:F
Credentials:MS, ATC, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 ELMWOOD AVE # HOUS109
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1004
Mailing Address - Country:US
Mailing Address - Phone:716-878-3871
Mailing Address - Fax:716-878-3536
Practice Address - Street 1:1300 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-1004
Practice Address - Country:US
Practice Address - Phone:716-878-3871
Practice Address - Fax:716-878-3536
Is Sole Proprietor?:No
Enumeration Date:2014-08-31
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X, 390200000X
NY003182-012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program