Provider Demographics
NPI:1992010946
Name:SPECHT, RACHEL D (LAC , MSTOM)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:D
Last Name:SPECHT
Suffix:
Gender:F
Credentials:LAC , MSTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-3614
Mailing Address - Country:US
Mailing Address - Phone:973-453-6400
Mailing Address - Fax:973-453-6399
Practice Address - Street 1:200 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866
Practice Address - Country:US
Practice Address - Phone:973-453-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-15
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00076500171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist