Provider Demographics
NPI:1275607996
Name:GAMBINO, RACHEL MARGARET (PT DPT)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:MARGARET
Last Name:GAMBINO
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
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Mailing Address - Street 1:131 FIRST STREET
Mailing Address - Street 2:RACHEL M GAMBINO
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741
Mailing Address - Country:US
Mailing Address - Phone:516-984-2615
Mailing Address - Fax:
Practice Address - Street 1:1228 WANTAGH AVENUE
Practice Address - Street 2:SUITE 104 SOUTH SHORE PEDIATRIC PHYSICAL THERAPY LLP
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793
Practice Address - Country:US
Practice Address - Phone:516-785-5257
Practice Address - Fax:516-785-5154
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY01675012251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
30648OtherANTHEM LINDA
Q3107OtherKAREN BLCR BLSH
30646OtherANTHEM KAREN
A745513OtherOXFORD
Q09X41OtherJP BLCR BLSH
NYQQ8132OtherBCBS PPO EPO
QQ8131OtherRACHEL BLCR BLSH HMO
60101OtherCIGNA PPO PROVID # PAYOR
NYQQ8131OtherBCBS HMO
Q6337OtherLINDA BLCR BLSH