Provider Demographics
NPI:1780829549
Name:HARRY, RACHEL KELLY (PT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:KELLY
Last Name:HARRY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:KELLY
Other - Last Name:GAZSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1603 COURT ST.
Mailing Address - Street 2:ENABLE
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13208
Mailing Address - Country:US
Mailing Address - Phone:315-455-7591
Mailing Address - Fax:315-455-2494
Practice Address - Street 1:620 W. GENESEE ST.
Practice Address - Street 2:EXPLORING YOUR WORLD NURSERY SCHOOL
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204
Practice Address - Country:US
Practice Address - Phone:315-218-0296
Practice Address - Fax:315-471-6028
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist