Provider Demographics
NPI:1225710718
Name:GUEVARRA, RACHEL MOISES (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MOISES
Last Name:GUEVARRA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1236
Mailing Address - Country:US
Mailing Address - Phone:201-895-0124
Mailing Address - Fax:
Practice Address - Street 1:941 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2601
Practice Address - Country:US
Practice Address - Phone:732-264-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant