Provider Demographics
NPI:1205402401
Name:SOCHA, RACHAEL (RDT)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:SOCHA
Suffix:
Gender:F
Credentials:RDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 SIGEL ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-2122
Mailing Address - Country:US
Mailing Address - Phone:610-348-0163
Mailing Address - Fax:
Practice Address - Street 1:1327 SIGEL ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2122
Practice Address - Country:US
Practice Address - Phone:610-348-0163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA603