Provider Demographics
NPI:1609039015
Name:VOLKOWITZ, RACQUEL M (PA)
Entity Type:Individual
Prefix:
First Name:RACQUEL
Middle Name:M
Last Name:VOLKOWITZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1810 E 33RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4426
Mailing Address - Country:US
Mailing Address - Phone:718-854-4256
Mailing Address - Fax:
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-3148
Practice Address - Fax:718-780-3287
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY011025363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant