Provider Demographics
NPI:1164114575
Name:BUSH, RACHEL S (CRPA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:S
Last Name:BUSH
Suffix:
Gender:F
Credentials:CRPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COTTAGE PL FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4201
Mailing Address - Country:US
Mailing Address - Phone:914-235-6633
Mailing Address - Fax:914-633-3319
Practice Address - Street 1:3 COTTAGE PL FL 2
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4201
Practice Address - Country:US
Practice Address - Phone:914-235-6633
Practice Address - Fax:914-633-3319
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCRPA-P-5053175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist