Provider Demographics
NPI:1336307438
Name:WARD, RACHEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:A
Last Name:WARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:135 OCEAN PKWY APT 1P
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2579
Mailing Address - Country:US
Mailing Address - Phone:718-568-6061
Mailing Address - Fax:415-728-9704
Practice Address - Street 1:135 OCEAN PKWY APT 1P
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2579
Practice Address - Country:US
Practice Address - Phone:718-568-6061
Practice Address - Fax:415-728-9704
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD194082084P0800X
MI43011045312084P0800X
NY2935592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME002942003Medicare UPIN