Provider Demographics
NPI:1609841808
Name:TARTAGLIA, RACHEL (CPNP)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:TARTAGLIA
Suffix:
Gender:F
Credentials:CPNP
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Mailing Address - Street 1:294 N MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-1838
Mailing Address - Country:US
Mailing Address - Phone:413-525-1870
Mailing Address - Fax:413-525-3883
Practice Address - Street 1:294 N MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-1838
Practice Address - Country:US
Practice Address - Phone:413-525-1870
Practice Address - Fax:413-525-3883
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA202492363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9732314Medicaid