Provider Demographics
NPI:1255582193
Name:PENNEY, RACHEL (OD)
Entity type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:
Last Name:PENNEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 LONG RUN RD
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-7427
Mailing Address - Country:US
Mailing Address - Phone:412-751-5609
Mailing Address - Fax:
Practice Address - Street 1:722 LONG RUN RD
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-7427
Practice Address - Country:US
Practice Address - Phone:412-751-5609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002728152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist