Provider Demographics
NPI:1811437957
Name:STERN, RACHEL (PHARMD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:STERN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:TENNENBAUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1247 BEACH 9TH ST
Mailing Address - Street 2:APT 2D
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1247 BEACH 9TH ST
Practice Address - Street 2:APT 2D
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4847
Practice Address - Country:US
Practice Address - Phone:917-620-0120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061724-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist