Provider Demographics
NPI:1659718211
Name:MEADE, RACHEL (LMT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MEADE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 VEGOLA AVE
Mailing Address - Street 2:UPPER
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-5021
Mailing Address - Country:US
Mailing Address - Phone:607-280-9026
Mailing Address - Fax:
Practice Address - Street 1:73 VEGOLA AVE
Practice Address - Street 2:UPPER
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-5021
Practice Address - Country:US
Practice Address - Phone:607-280-9026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025591225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist