Provider Demographics
NPI:1851010029
Name:FLORES, RAHUCHEL
Entity Type:Individual
Prefix:
First Name:RAHUCHEL
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6596 ROUT 55
Mailing Address - Street 2:
Mailing Address - City:WINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:12594
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6596 ROUT 55
Practice Address - Street 2:
Practice Address - City:WINGDALE
Practice Address - State:NY
Practice Address - Zip Code:12594
Practice Address - Country:US
Practice Address - Phone:845-260-1350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY805028163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse