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General NPI Number Information
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NPI Number | 1194237412
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Entity Type | Organization
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Legal Business Name | RACHAEL TIMBERLAKE
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 10/26/2017
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Provider Practice Location Address
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Address Line | 20 W 20TH ST STE 1002
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City | NEW YORK
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State | NY
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Zip | 10011-9252
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Country | US
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Telephone | 917-214-7123
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Fax |
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Provider Business Mailing Address
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Address Line | 221 E 18TH ST APT 6J
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City | BROOKLYN
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State | NY
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Zip | 11226-4732
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Country | US
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Telephone | 917-214-7123
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | RACHAEL TIMBERLAKE
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Credential | L.AC.
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Telephone | 917-214-7123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 002549
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License Number State | NY
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