Provider Demographics
NPI:1457838856
Name:SCHALLER, RACHEL (MSW/CARE COORDINATOR)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SCHALLER
Suffix:
Gender:F
Credentials:MSW/CARE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ROUTE 111
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3754
Mailing Address - Country:US
Mailing Address - Phone:631-764-8275
Mailing Address - Fax:
Practice Address - Street 1:14202 20TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11351
Practice Address - Country:US
Practice Address - Phone:917-563-3310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program