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General NPI Number Information
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NPI Number | 1619265170
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Entity Type | Individual
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Provider Name | DR. RACHEL TEHRANI
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Gender | Female
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 728 N MAIN ST
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City | NEW SQUARE
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State | NY
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Zip | 10977-8916
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Country | US
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Telephone | 845-354-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 WAYNE AVE APT 18B
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City | BRONX
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State | NY
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Zip | 10467-2510
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 265362-1
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License Number State | NY
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