Provider Demographics
NPI:1821814849
Name:CONWAY, RACHEL (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:CONWAY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BENNETT AVE APT 8B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3839
Mailing Address - Country:US
Mailing Address - Phone:845-641-4140
Mailing Address - Fax:
Practice Address - Street 1:315 MADISON AVE BSMT 99
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5457
Practice Address - Country:US
Practice Address - Phone:917-715-4665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053603225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist