Healthcare Provider Details

I. General information

NPI: 1508297409
Provider Name (Legal Business Name): RACHEL WRIGHT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 06/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 NEW DORP LN
STATEN ISLAND NY
10306-2351
US

IV. Provider business mailing address

65 BROADWAY STE 1803
NEW YORK NY
10006-2514
US

V. Phone/Fax

Practice location:
  • Phone: 718-370-3500
  • Fax: 718-979-5236
Mailing address:
  • Phone: 212-514-6499
  • Fax: 212-514-6475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number037048
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: