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NPI Code Detail

MEDICARE: RACHEL GROTTOLA

MEDICARE:   RACHEL  GROTTOLA
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1922954288
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL GROTTOLA
Provider Business Mailing Address
First Line : 219 HALLOCK RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3021
Country : US
Telephone Number : 631-804-4203
Fax Number :
Provider Business Practice Location Address
First Line : 65 MASPETH AVE STE 2A
Second Line :
City : BROOKLYN
State : NY
Zip : 11211-6817
Country : US
Telephone Number : 929-210-9333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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Directions to “ RACHEL GROTTOLA ” Practice Location

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