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General NPI Number Information
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NPI Number | 1831476076
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Entity Type | Individual
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Provider Name | RACHEL SUN D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2011
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 147 ROOSEVELT AVE UNIT 15C
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City | FLUSHING
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State | NY
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Zip | 11354-4757
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Country | US
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Telephone | 646-596-5134
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Fax |
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Provider Business Mailing Address
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Address Line | 147 ROOSEVELT AVE UNIT 15C
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City | FLUSHING
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State | NY
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Zip | 11354-4757
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Country | US
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Telephone | 646-596-5134
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 053023
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License Number State | NY
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