Provider Demographics
NPI:1295281830
Name:LARKEY, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:LARKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 TUCKAHOE ROAD
Mailing Address - Street 2:1053
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710
Mailing Address - Country:US
Mailing Address - Phone:973-747-8588
Mailing Address - Fax:718-486-5741
Practice Address - Street 1:465 TUCKAHOE RD # 1053
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-5707
Practice Address - Country:US
Practice Address - Phone:973-747-8588
Practice Address - Fax:833-397-1875
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008685-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
WI331944Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
WI331952Medicare Oscar/Certification
WI331945Medicare Oscar/Certification
WI331058Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
WI331978Medicare Oscar/Certification
WI331009Medicare Oscar/Certification
NY00695941Medicaid
WI331043Medicare Oscar/Certification
WI331946Medicare Oscar/Certification
WI331947Medicare Oscar/Certification
WI331954Medicare Oscar/Certification