Provider Demographics
NPI:1578667598
Name:WILLIAMS, RACHEL (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:3534 RIVERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1804
Mailing Address - Country:US
Mailing Address - Phone:347-427-4228
Mailing Address - Fax:347-503-0972
Practice Address - Street 1:3601 FIELDSTON RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2003
Practice Address - Country:US
Practice Address - Phone:347-427-4228
Practice Address - Fax:347-503-0972
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0258031261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy