Healthcare Provider Details

I. General information

NPI: 1497093595
Provider Name (Legal Business Name): RACHEL GENNAOUI ABAD APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 05/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 ROUTE 73
VOORHEES NJ
08043
US

IV. Provider business mailing address

1104 S BURNT MILL RD
VOORHEES NJ
08043-2217
US

V. Phone/Fax

Practice location:
  • Phone: 856-809-3500
  • Fax:
Mailing address:
  • Phone: 856-278-1002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP012359
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: