Provider Demographics
NPI:1417542713
Name:APARIS, RACHELLE AISHA
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:AISHA
Last Name:APARIS
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 1:300 E 3RD ST APT 205
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-3350
Mailing Address - Country:US
Mailing Address - Phone:347-946-4958
Mailing Address - Fax:
Practice Address - Street 1:300 E 3RD ST APT 205
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-3350
Practice Address - Country:US
Practice Address - Phone:347-946-4958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037656-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYLGM2501143OtherDIRECT HEALTH