Provider Demographics
NPI:1568714715
Name:RAYMOND, RACHEL L (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:L
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:L
Other - Last Name:KUSZAJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 BROOKS LN STE 130
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3749
Mailing Address - Country:US
Mailing Address - Phone:412-460-8111
Mailing Address - Fax:412-460-8112
Practice Address - Street 1:1200 BROOKS LN STE 130
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025
Practice Address - Country:US
Practice Address - Phone:412-460-8111
Practice Address - Fax:412-460-8112
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055737363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant