Provider Demographics
NPI:1609186972
Name:FUTERSAK, RACHELLE (MS)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:FUTERSAK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 BRYANT DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1834
Mailing Address - Country:US
Mailing Address - Phone:646-271-5028
Mailing Address - Fax:
Practice Address - Street 1:36 BRYANT DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1834
Practice Address - Country:US
Practice Address - Phone:646-271-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist