Provider Demographics
NPI:1982700274
Name:TOTORO, RACHEL WEINRYB (DO)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:WEINRYB
Last Name:TOTORO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:WEINRYB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPARTMENT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:904-697-4203
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:255 WEST LANCASTER AVE SUITE 101
Practice Address - Street 2:NEMOURS DUPONT PEDIATRICS, PAOLI
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-644-9380
Practice Address - Fax:610-644-4872
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05-009433L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01708422Medicaid
G78019Medicare UPIN
PA01708422Medicaid