Provider Demographics
NPI:1225248966
Name:COYLE, RACHEL HAYDAK (MS, PT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:HAYDAK
Last Name:COYLE
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:A
Other - Last Name:HAYDAK COYLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,PT
Mailing Address - Street 1:580 STATE ROUTE 208
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1738
Mailing Address - Country:US
Mailing Address - Phone:845-492-2060
Mailing Address - Fax:
Practice Address - Street 1:580 STATE ROUTE 208
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1738
Practice Address - Country:US
Practice Address - Phone:845-492-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022646-1225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics