Provider Demographics
NPI:1457378986
Name:PACHMAN, ROCHELLE ALTARAC (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:ALTARAC
Last Name:PACHMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2539 MIDDLE COUNTRY RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-3551
Mailing Address - Country:US
Mailing Address - Phone:631-737-6434
Mailing Address - Fax:631-738-1226
Practice Address - Street 1:2539 MIDDLE COUNTRY RD
Practice Address - Street 2:SUITE 4 EAST END NEUROPSYCHIATRIC ASSOC
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-3551
Practice Address - Country:US
Practice Address - Phone:631-737-6434
Practice Address - Fax:631-738-1226
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0730471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N16892Medicare UPIN
RP0N168920Medicare ID - Type Unspecified