Provider Demographics
NPI:1922137363
Name:SCHWIEBERT, RACHEL ANN (MSED)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ANN
Last Name:SCHWIEBERT
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 WAVERLY AVE
Mailing Address - Street 2:APARTMENT 9D
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-1900
Mailing Address - Country:US
Mailing Address - Phone:631-880-9066
Mailing Address - Fax:
Practice Address - Street 1:99 WAVERLY AVE
Practice Address - Street 2:APARTMENT 9D
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1900
Practice Address - Country:US
Practice Address - Phone:631-880-9066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor