Healthcare Provider Details

I. General information

NPI: 1992447346
Provider Name (Legal Business Name): RACHEL KRISTINA MOYER MCCOOL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL KRISTINA MOYER

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 CLINTON AVE S
ROCHESTER NY
14620-1448
US

IV. Provider business mailing address

777 CLINTON AVE S
ROCHESTER NY
14620-1448
US

V. Phone/Fax

Practice location:
  • Phone: 585-279-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33461
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: