Healthcare Provider Details

I. General information

NPI: 1760861488
Provider Name (Legal Business Name): MRS. RACHEL ELIZABETH HALE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2015
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 LAKEWOOD AVE
MONTICELLO NY
12701-2021
US

IV. Provider business mailing address

23 LAKEWOOD AVE
MONTICELLO NY
12701-2021
US

V. Phone/Fax

Practice location:
  • Phone: 845-794-2010
  • Fax:
Mailing address:
  • Phone: 845-794-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number835744-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number002294
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: