Provider Demographics
NPI:1710380076
Name:ROMBOUGH, RACHEL E
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:ROMBOUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:E
Other - Last Name:SCHONFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:321 GIFFORD ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-3201
Mailing Address - Country:US
Mailing Address - Phone:315-703-2600
Mailing Address - Fax:315-703-2621
Practice Address - Street 1:321 GIFFORD ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-3201
Practice Address - Country:US
Practice Address - Phone:315-703-2600
Practice Address - Fax:315-703-2621
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily