Provider Demographics
NPI:1972792422
Name:GEORGE, RACHEL (FNP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4256 BRONX BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2673
Mailing Address - Country:US
Mailing Address - Phone:718-515-4347
Mailing Address - Fax:718-653-8641
Practice Address - Street 1:4256 BRONX BLVD STE 5
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2673
Practice Address - Country:US
Practice Address - Phone:718-515-4347
Practice Address - Fax:718-653-8641
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY475434163WH0200X
NYF342799363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH0200XNursing Service ProvidersRegistered NurseHome Health