Provider Demographics
NPI:1861656837
Name:BILELLO, RACHAEL GREEN (DO)
Entity Type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:GREEN
Last Name:BILELLO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 N BROADWAY STE L2
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2109
Mailing Address - Country:US
Mailing Address - Phone:516-931-1776
Mailing Address - Fax:516-942-1940
Practice Address - Street 1:380 N BROADWAY
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753
Practice Address - Country:US
Practice Address - Phone:866-621-2769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247401208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics