Provider Demographics
NPI:1215382577
Name:MIRSCH, RACHEL RAFFERTY (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:RAFFERTY
Last Name:MIRSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:ASHLEY
Other - Last Name:RAFFERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 MAIN ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1009
Mailing Address - Country:US
Mailing Address - Phone:716-323-0034
Mailing Address - Fax:716-323-0292
Practice Address - Street 1:818 ELLICOTT ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1021
Practice Address - Country:US
Practice Address - Phone:716-323-0034
Practice Address - Fax:716-323-0292
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-24
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY301145208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program