Healthcare Provider Details

I. General information

NPI: 1124963517
Provider Name (Legal Business Name): RAHI RN WELLNESS CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 E 169TH ST FRNT 2
BRONX NY
10456-2411
US

IV. Provider business mailing address

140 WADSWORTH AVE APT 23
NEW YORK NY
10033-4817
US

V. Phone/Fax

Practice location:
  • Phone: 917-916-9322
  • Fax:
Mailing address:
  • Phone: 917-916-9322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: RAUL ALEJANDRO HERRERA IZQUIERDO
Title or Position: OWNER/MANAGING MEMBERS
Credential: MSN, FNP-BC, CMGT-BC
Phone: 917-916-9322