Provider Demographics
NPI:1235814443
Name:ROSENBLUM SCHWAB, RACHEL SHARON
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SHARON
Last Name:ROSENBLUM SCHWAB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W 239TH ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1214
Mailing Address - Country:US
Mailing Address - Phone:908-616-0125
Mailing Address - Fax:
Practice Address - Street 1:611 W 239TH ST APT 3A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1214
Practice Address - Country:US
Practice Address - Phone:908-616-0125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1336918191174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist