Provider Demographics
NPI:1336685734
Name:SILVERSTEIN, RACHEL NICOLE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:NICOLE
Last Name:SILVERSTEIN
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 1:3863 RIVE GAUCHE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-2440
Mailing Address - Country:US
Mailing Address - Phone:630-450-0824
Mailing Address - Fax:
Practice Address - Street 1:101 S RAINBOW BLVD
Practice Address - Street 2:STE 1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5362
Practice Address - Country:US
Practice Address - Phone:630-450-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1336685734Medicaid