Provider Demographics
NPI:1811678345
Name:GERSH, RACHEL ANNE (NP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE
Last Name:GERSH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 BEACH 143RD ST
Mailing Address - Street 2:
Mailing Address - City:NEPONSIT
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1108
Mailing Address - Country:US
Mailing Address - Phone:347-426-8004
Mailing Address - Fax:
Practice Address - Street 1:104 W 40TH ST STE 416
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3617
Practice Address - Country:US
Practice Address - Phone:888-753-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY76659001163W00000X
NYF40476901363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse