Provider Demographics
NPI:1376181222
Name:AMADO, RACHEL ISABELLE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ISABELLE
Last Name:AMADO
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 1:100 KINGS HWY S STE 2500
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5509
Mailing Address - Country:US
Mailing Address - Phone:585-922-1504
Mailing Address - Fax:585-922-1524
Practice Address - Street 1:100 KINGS HWY S STE 2500
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-5509
Practice Address - Country:US
Practice Address - Phone:585-922-1504
Practice Address - Fax:585-922-1524
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator