Provider Demographics
NPI:1790391407
Name:FILTER, RACHEL DANIELLE (CPNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DANIELLE
Last Name:FILTER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2326
Mailing Address - Country:US
Mailing Address - Phone:718-859-6440
Mailing Address - Fax:718-434-0368
Practice Address - Street 1:2704 GLENWOOD RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2326
Practice Address - Country:US
Practice Address - Phone:718-859-6440
Practice Address - Fax:718-434-0368
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF383129208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics