Provider Demographics
NPI:1649685934
Name:DAVID, RACHEL ESTHER (DMD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ESTHER
Last Name:DAVID
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:ESTHER
Other - Last Name:GITTLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:457 FDR DR APT A504
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-1922
Mailing Address - Country:US
Mailing Address - Phone:908-910-3433
Mailing Address - Fax:
Practice Address - Street 1:457 FDR DR APT A504
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-1922
Practice Address - Country:US
Practice Address - Phone:908-910-3433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02568800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist