MEDICARE: RACHEL LASTER RD, RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian		NY

General Provider Information

NPI Number	:	1063023505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL LASTER RD, RDN

Provider Business Mailing Address
First Line	:	33 MANHART ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215-3224
Country	:	US
Telephone Number	:	716-812-1577
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 MANHART ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215-3224
Country	:	US
Telephone Number	:	716-812-1577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2020
Last Update Date	:	08/10/2020

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