Provider Demographics
NPI:1730136326
Name:BOJER, RACHELLE (MS PT)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:BOJER
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2738
Mailing Address - Country:US
Mailing Address - Phone:631-629-5507
Mailing Address - Fax:
Practice Address - Street 1:11 STEWART AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2738
Practice Address - Country:US
Practice Address - Phone:631-629-5507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022578225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q14T01OtherBCBS
P2835952OtherOXFORD
NYQL2322Medicare PIN