Provider Demographics
NPI:1740212778
Name:MALDONADO, RACHEL DAVIDSON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:DAVIDSON
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 CLARKSON AVE,
Mailing Address - Street 2:R BUILDING, DEPT OF CHILD AND ADOLESCENT PSYCHIATRY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203
Mailing Address - Country:US
Mailing Address - Phone:646-554-6992
Mailing Address - Fax:
Practice Address - Street 1:KINGS COUNTY HOSPITAL CENTER
Practice Address - Street 2:451 CLARKSON AVENUE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-245-2479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016794103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical