MEDICARE: MS. RACHEL GOLDSTEIN CBC, CD, MA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	174H00000X	Health Educator
2	174N00000X	Lactation Consultant (Non-RN)
3	374J00000X	Doula

General Provider Information

NPI Number	:	1407408636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RACHEL GOLDSTEIN CBC, CD, MA

Provider Business Mailing Address
First Line	:	PO BOX 720424
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-0424
Country	:	US
Telephone Number	:	917-855-8865
Fax Number	:

Provider Business Practice Location Address
First Line	:	3528 77TH ST APT 51
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-4580
Country	:	US
Telephone Number	:	917-855-8865
Fax Number	:

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

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	07/09/2019

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