Provider Demographics
NPI:1346418209
Name:SARILL, RACHEL MARA
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARA
Last Name:SARILL
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 1:9 QUAIL COURT
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2025 BROADWAY
Practice Address - Street 2:APT 5F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5038
Practice Address - Country:US
Practice Address - Phone:718-350-3171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002196-1231H00000X
NJ41YA00071700231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist