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NPI Code Detail

MEDICARE: MS. RACHEL MARIE RIFANBURG LMT

MEDICARE: MS. RACHEL MARIE RIFANBURG LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist024234NY

General Provider Information

NPI Number : 1093221756
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RACHEL MARIE RIFANBURG LMT
Provider Business Mailing Address
First Line : 3070 BELGIUM RD
Second Line :
City : BALDWINSVILLE
State : NY
Zip : 13027-9546
Country : US
Telephone Number : 315-224-5564
Fax Number :
Provider Business Practice Location Address
First Line : 3070 BELGIUM RD
Second Line :
City : BALDWINSVILLE
State : NY
Zip : 13027-9546
Country : US
Telephone Number : 315-224-5564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2017
Last Update Date : 12/18/2017

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