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General NPI Number Information
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NPI Number | 1710613948
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Entity Type | Individual
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Provider Name | RACHEL GORGY OD
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Gender | Female
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 1501 SAN PEDRO DR SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-5153
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Country | US
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Telephone | 505-265-1711
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Fax |
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Provider Business Mailing Address
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Address Line | 10 N GREENE ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1524
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Country | US
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Telephone | 646-641-4208
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.0003956
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License Number State | CO
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