Provider Demographics
NPI:1497766513
Name:RACHLIN, STEPHEN L (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:RACHLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 100
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:NY
Mailing Address - Zip Code:10548-0100
Mailing Address - Country:US
Mailing Address - Phone:914-737-4400
Mailing Address - Fax:914-788-4268
Practice Address - Street 1:VA HUDSON VALLEY HCS ROUTE 9A
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548-0100
Practice Address - Country:US
Practice Address - Phone:914-737-4400
Practice Address - Fax:914-788-4268
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0152742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP00253449OtherRAILROAD MEDICARE
CT260004159Medicare PIN
CTP00253449OtherRAILROAD MEDICARE