Healthcare Provider Details

I. General information

NPI: 1043542665
Provider Name (Legal Business Name): RACHEL JOANNA ESQUILIN L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2010
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 UNION ST GROUND FLOOR
BROOKLYN NY
11215-1418
US

IV. Provider business mailing address

507 PARK PL APT 2
BROOKLYN NY
11238-4679
US

V. Phone/Fax

Practice location:
  • Phone: 347-260-3072
  • Fax:
Mailing address:
  • Phone: 347-260-3072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004243-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: