Healthcare Provider Details

I. General information

NPI: 1700081304
Provider Name (Legal Business Name): RACHEL AVGUSH R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 ARLINGTON AVE
BRONX NY
10471-1302
US

IV. Provider business mailing address

6015 INDEPENDENCE AVE
BRONX NY
10471-1248
US

V. Phone/Fax

Practice location:
  • Phone: 718-796-1190
  • Fax:
Mailing address:
  • Phone: 718-796-5462
  • Fax: 718-796-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number403685-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: