Provider Demographics
NPI:1366819229
Name:KURZ, RACHEL LEAH (RPA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEAH
Last Name:KURZ
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 OCEAN PKWY APT 2D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6435
Mailing Address - Country:US
Mailing Address - Phone:347-266-5382
Mailing Address - Fax:
Practice Address - Street 1:1440 OCEAN PKWY APT 2D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6435
Practice Address - Country:US
Practice Address - Phone:347-266-5382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018396363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical