Healthcare Provider Details

I. General information

NPI: 1144651647
Provider Name (Legal Business Name): RACHEL YASHIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 03/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 OLD YORK RD
ABINGTON PA
19001-3720
US

IV. Provider business mailing address

10021 BRIDLE RD 2ND FLR
PHILADELPHIA PA
19116-3601
US

V. Phone/Fax

Practice location:
  • Phone: 215-481-2336
  • Fax:
Mailing address:
  • Phone: 215-317-7333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number100492
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: