Provider Demographics
NPI:1376768960
Name:EFRON, RACHEL CHARLOTTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:CHARLOTTE
Last Name:EFRON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 PROSPECT PL
Mailing Address - Street 2:#1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2804
Mailing Address - Country:US
Mailing Address - Phone:718-230-5134
Mailing Address - Fax:
Practice Address - Street 1:110 PROSPECT PL
Practice Address - Street 2:#1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2804
Practice Address - Country:US
Practice Address - Phone:718-230-5134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008748-01103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV67991Medicare ID - Type Unspecified