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General NPI Number Information
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NPI Number | 1194467415
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Entity Type | Individual
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Provider Name | RHEBA RACHEL SAM DO
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Gender | Female
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Dates
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Enumeration Date | 04/07/2022
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 945 SUMMER ST FL 3
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City | STAMFORD
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State | CT
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Zip | 06905-5519
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Country | US
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Telephone | 203-327-9321
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Fax |
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Provider Business Mailing Address
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Address Line | 945 SUMMER ST FL 3
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City | STAMFORD
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State | CT
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Zip | 06905-5519
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Country | US
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Telephone | 203-327-9321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 81156
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License Number State | CT
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