Provider Demographics
NPI:1114379013
Name:HEMETER, RACHEL LEE (PA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEE
Last Name:HEMETER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LEE
Other - Last Name:UNGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5A MEDICAL PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970
Mailing Address - Country:US
Mailing Address - Phone:973-865-0821
Mailing Address - Fax:973-509-8333
Practice Address - Street 1:5A MEDICAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970
Practice Address - Country:US
Practice Address - Phone:845-362-0075
Practice Address - Fax:973-509-8333
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019757-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant