Provider Demographics
NPI:1851360432
Name:CAGNER, RACHEL BETH (PT)
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:BETH
Last Name:CAGNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 E 66TH ST
Mailing Address - Street 2:APT.12G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-6404
Mailing Address - Country:US
Mailing Address - Phone:646-221-2344
Mailing Address - Fax:
Practice Address - Street 1:244 E 84TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2902
Practice Address - Country:US
Practice Address - Phone:212-570-0209
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0232641225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist