Healthcare Provider Details

I. General information

NPI: 1003479767
Provider Name (Legal Business Name): MRS. RACHELLE MARY PARTRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 LIBERTY STREET
BATH NY
14810-1124
US

IV. Provider business mailing address

33 DENISON PARKWAY WEST
CORNING NY
14830-2613
US

V. Phone/Fax

Practice location:
  • Phone: 607-936-1771
  • Fax:
Mailing address:
  • Phone: 607-937-4560
  • Fax: 607-937-3205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number095099
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ5-0000293
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: