Provider Demographics
NPI:1437516176
Name:SKOLNICK, RACHEL HOLLY (DC,)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:HOLLY
Last Name:SKOLNICK
Suffix:
Gender:F
Credentials:DC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BEAUMONT DR
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3401
Mailing Address - Country:US
Mailing Address - Phone:631-253-2423
Mailing Address - Fax:
Practice Address - Street 1:19 BEAUMONT DR
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3401
Practice Address - Country:US
Practice Address - Phone:631-253-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012782111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor