Healthcare Provider Details

I. General information

NPI: 1841180999
Provider Name (Legal Business Name): RACHEL DOMOND NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 CLEMENTE PL
HEMPSTEAD NY
11550-5103
US

IV. Provider business mailing address

17 CLEMENTE PL
HEMPSTEAD NY
11550-5103
US

V. Phone/Fax

Practice location:
  • Phone: 917-554-5832
  • Fax:
Mailing address:
  • Phone: 917-554-5832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number407149
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: