Provider Demographics
NPI:1245250653
Name:THOMPSON, RACHEL GOELLNER (PT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:GOELLNER
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:GUILSHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:161 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2647
Mailing Address - Country:US
Mailing Address - Phone:973-627-7888
Mailing Address - Fax:973-627-7040
Practice Address - Street 1:161 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2647
Practice Address - Country:US
Practice Address - Phone:973-627-7888
Practice Address - Fax:973-627-7040
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00814000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ055604N9UMedicare UPIN
NJP52446Medicare UPIN