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General NPI Number Information
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NPI Number | 1245643907
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Entity Type | Individual
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Provider Name | RACHEL BOHNEN DDS
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Gender | Female
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 13514 JEWEL AVE
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City | FLUSHING
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State | NY
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Zip | 11367-1920
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Country | US
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Telephone | 718-997-6453
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Fax |
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Provider Business Mailing Address
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Address Line | 400 CENTRAL PARK W APT 9E
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City | NEW YORK
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State | NY
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Zip | 10025-5880
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Country | US
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Telephone |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 058709-1
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License Number State | NY
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