Provider Demographics
NPI:1265838692
Name:MATAR, RACHEL Y (PA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:Y
Last Name:MATAR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:YINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:800 ROSE STREET, MN604
Mailing Address - Street 2:UK INTERNAL MEDICINE DIV OF HOSPITAL MEDICINE
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-323-6047
Mailing Address - Fax:859-257-3873
Practice Address - Street 1:800 ROSE STREET, MN604
Practice Address - Street 2:UK INTERNAL MEDICINE DIV OF HOSPITAL MEDICINE
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0298
Practice Address - Country:US
Practice Address - Phone:859-323-6047
Practice Address - Fax:859-257-3873
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-12
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTC351363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant