Healthcare Provider Details

I. General information

NPI: 1407763410
Provider Name (Legal Business Name): LAURA RACHAEL ZINSHTEYN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 FOREST AVE
WILLOW GROVE PA
19090-2835
US

IV. Provider business mailing address

347 FOREST AVE
WILLOW GROVE PA
19090-2835
US

V. Phone/Fax

Practice location:
  • Phone: 215-498-0931
  • Fax:
Mailing address:
  • Phone: 215-498-0931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP036920
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: