MEDICARE: RACHEAL KOREDE

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	106080	TX
2	163W00000X	Registered Nurse	768437-1	NY

General Provider Information

NPI Number	:	1295037380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEAL KOREDE

Provider Business Mailing Address
First Line	:	1 FARMINGDALE ROAD
Second Line	:	BUILDING 1
City	:	WEST BABYLON
State	:	NY
Zip	:	11704
Country	:	US
Telephone Number	:	631-321-8229
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 FARMINGDALE ROAD
Second Line	:	BUILDING 1
City	:	WEST BABYLON
State	:	NY
Zip	:	11704
Country	:	US
Telephone Number	:	631-321-8229
Fax Number	:

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

Provider Enumeration Date	:	11/23/2010
Last Update Date	:	02/09/2026

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Directions to “ RACHEAL KOREDE ” Practice Location

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