Healthcare Provider Details

I. General information

NPI: 1013023704
Provider Name (Legal Business Name): RACHELLE E NAMM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8008 3RD AVE
BROOKLYN NY
11209-3802
US

IV. Provider business mailing address

8008 3RD AVE
BROOKLYN NY
11209-3802
US

V. Phone/Fax

Practice location:
  • Phone: 718-833-3636
  • Fax: 718-833-2432
Mailing address:
  • Phone: 718-833-3636
  • Fax: 718-833-2432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA07949100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number237215
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: