Provider Demographics
NPI:1851043657
Name:ROBERT, RACHEAL ELIZABETH (MS)
Entity Type:Individual
Prefix:MS
First Name:RACHEAL
Middle Name:ELIZABETH
Last Name:ROBERT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5282
Mailing Address - Country:US
Mailing Address - Phone:518-435-0840
Mailing Address - Fax:
Practice Address - Street 1:1315 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5282
Practice Address - Country:US
Practice Address - Phone:518-435-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-22
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer