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General NPI Number Information
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NPI Number | 1477616944
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Entity Type | Individual
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Provider Name | RACHELLE NICHOLAS GATES P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 105 EVERETT RD
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City | ALBANY
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State | NY
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Zip | 12205-1407
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Country | US
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Telephone | 518-694-0999
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Fax | 518-694-0998
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Provider Business Mailing Address
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Address Line | 105 EVERETT RD
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City | ALBANY
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State | NY
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Zip | 12205-1407
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Country | US
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Telephone | 518-694-0999
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Fax | 518-694-0998
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 001204
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00191900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 012579-1
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License Number State | NY
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