Healthcare Provider Details

I. General information

NPI: 1033640057
Provider Name (Legal Business Name): RACHEL G. HIRSCHBERGER M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE PAVILION 129, HOUSESTAFF LOUNGE
BOSTON MA
02115
US

IV. Provider business mailing address

300 LONGWOOD AVE
BOSTON MA
02115-5724
US

V. Phone/Fax

Practice location:
  • Phone: 914-358-0188
  • Fax:
Mailing address:
  • Phone: 617-355-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number323466
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number323466
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: