Healthcare Provider Details

I. General information

NPI: 1679084347
Provider Name (Legal Business Name): RACHEL GITTLER PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL STRICKLER

II. Dates (important events)

Enumeration Date: 10/20/2017
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 LANCASTER AVE STE 200
MALVERN PA
19355-3256
US

IV. Provider business mailing address

PO BOX 5228
WEST CHESTER PA
19380-0405
US

V. Phone/Fax

Practice location:
  • Phone: 610-644-6900
  • Fax: 610-644-7160
Mailing address:
  • Phone: 610-359-5672
  • Fax: 610-644-7160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMA059409
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: