MEDICARE: RACHEL WARREN

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
1	174400000X	Specialist

General Provider Information

NPI Number	:	1215304316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL WARREN

Provider Business Mailing Address
First Line	:	155 NEWTON ST
Second Line	:	APT. 2R
City	:	BROOKLYN
State	:	NY
Zip	:	11222-4930
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 NEWTON ST
Second Line	:	APT. 2R
City	:	BROOKLYN
State	:	NY
Zip	:	11222-4930
Country	:	US
Telephone Number	:	914-441-8981
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2015
Last Update Date	:	08/25/2015

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Directions to “ RACHEL WARREN ” Practice Location

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