Healthcare Provider Details

I. General information

NPI: 1437516176
Provider Name (Legal Business Name): RACHEL HOLLY SKOLNICK D.C,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BEAUMONT DR
MELVILLE NY
11747-3401
US

IV. Provider business mailing address

19 BEAUMONT DR
MELVILLE NY
11747-3401
US

V. Phone/Fax

Practice location:
  • Phone: 631-253-2423
  • Fax:
Mailing address:
  • Phone: 631-253-2423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX012782
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: