Healthcare Provider Details

I. General information

NPI: 1417782566
Provider Name (Legal Business Name): RACHEL GEFFRARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 17TH ST STE 550
NEW YORK NY
10003-3804
US

IV. Provider business mailing address

301 E 17TH ST # 550
NEW YORK NY
10003-3804
US

V. Phone/Fax

Practice location:
  • Phone: 212-598-6422
  • Fax:
Mailing address:
  • Phone: 212-598-6422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF353077-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF353077-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: