Provider Demographics
NPI:1518547314
Name:ANDRE, RACHEL A
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:ANDRE
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 1:395 OCEAN AVE APT 4J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1711
Mailing Address - Country:US
Mailing Address - Phone:646-678-0454
Mailing Address - Fax:
Practice Address - Street 1:395 OCEAN AVE APT 4J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1711
Practice Address - Country:US
Practice Address - Phone:646-678-0454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174N00000X, 374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN