Healthcare Provider Details

I. General information

NPI: 1649791104
Provider Name (Legal Business Name): RACHEL SANDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date: 06/13/2023
Reactivation Date: 11/21/2023

III. Provider practice location address

79- 20TH AVENUE
BROOKLYN NY
11214
US

IV. Provider business mailing address

1 CLUB DR APT 4EL
WOODMERE NY
11598-2007
US

V. Phone/Fax

Practice location:
  • Phone: 917-652-9506
  • Fax:
Mailing address:
  • Phone: 610-209-7287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License Number729890-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NR23741500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: