Provider Demographics
NPI:1831743905
Name:MCNAMARA, RACHEL (PT)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:DIBENEDETTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:299 HALLOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-1217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:51 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-3422
Practice Address - Country:US
Practice Address - Phone:718-344-8340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-28
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist