Provider Demographics
NPI:1780934042
Name:FOCKLER, RAECHEL ANN (DO)
Entity type:Individual
Prefix:DR
First Name:RAECHEL
Middle Name:ANN
Last Name:FOCKLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:RAECHEL
Other - Middle Name:ANN
Other - Last Name:GRABSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 71417
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19176-1417
Mailing Address - Country:US
Mailing Address - Phone:856-669-6025
Mailing Address - Fax:856-651-0794
Practice Address - Street 1:2950 COLLEGE DR
Practice Address - Street 2:SUITE 2F
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6933
Practice Address - Country:US
Practice Address - Phone:856-205-0606
Practice Address - Fax:856-205-0044
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09719200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology