Provider Demographics
NPI:1518226125
Name:FAULKNER, RACHAEL ANN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:ANN
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:RACHAEL
Other - Middle Name:ANN
Other - Last Name:PASSETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:7 TIMMERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13452-1017
Mailing Address - Country:US
Mailing Address - Phone:518-568-5037
Mailing Address - Fax:518-568-7505
Practice Address - Street 1:7 TIMMERMAN AVE
Practice Address - Street 2:
Practice Address - City:ST JOHNSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13452-1017
Practice Address - Country:US
Practice Address - Phone:518-568-5037
Practice Address - Fax:518-568-7505
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist