Provider Demographics
NPI:1811407638
Name:NERGART, RACHAEL CHRISTINE (PA)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:CHRISTINE
Last Name:NERGART
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 QUARRY DR STE C34
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1153
Mailing Address - Country:US
Mailing Address - Phone:610-678-7000
Mailing Address - Fax:610-678-6688
Practice Address - Street 1:2209 QUARRY DR STE C34
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19609-1153
Practice Address - Country:US
Practice Address - Phone:610-678-7000
Practice Address - Fax:610-678-6688
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059369207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine