Provider Demographics
NPI:1720611312
Name:VANDERLAAN, RACHEL DAWN (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:DAWN
Last Name:VANDERLAAN
Suffix:
Gender:F
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 W 165TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-7912
Mailing Address - Country:US
Mailing Address - Phone:416-262-8810
Mailing Address - Fax:
Practice Address - Street 1:NEWYORK-PRESBYTERIAN MORGAN STANLEY CHILDREN'S HOSPITAL
Practice Address - Street 2:3959 BROADWAY AVE SUITE: 274
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-2688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300560208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)