Provider Demographics
NPI:1639135627
Name:RACHLIN, ISABEL (PT)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:RACHLIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 TROY RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-9473
Mailing Address - Country:US
Mailing Address - Phone:607-273-2506
Mailing Address - Fax:607-273-2506
Practice Address - Street 1:309 N AURORA ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4230
Practice Address - Country:US
Practice Address - Phone:607-273-2506
Practice Address - Fax:607-273-2506
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2012-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC3504Medicare ID - Type Unspecified