Provider Demographics
NPI:1306823935
Name:HALEVY-AVGUSH, RACHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:HALEVY-AVGUSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:HALEVY
Other - Last Name:AVGUSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2 SUFFERN LN
Mailing Address - Street 2:
Mailing Address - City:GARNERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10923-1311
Mailing Address - Country:US
Mailing Address - Phone:845-429-1800
Mailing Address - Fax:845-947-4198
Practice Address - Street 1:2 SUFFERN LN
Practice Address - Street 2:
Practice Address - City:GARNERVILLE
Practice Address - State:NY
Practice Address - Zip Code:10923-1311
Practice Address - Country:US
Practice Address - Phone:845-429-1800
Practice Address - Fax:845-947-4198
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173868207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01606220Medicaid
NYG21988Medicare UPIN