MEDICARE: DR. RACHELE MARGARET SIEGEL OD

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	152W00000X	Optometrist	OEG003285	PA

General Provider Information

NPI Number	:	1407385362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHELE MARGARET SIEGEL OD

Provider Business Mailing Address
First Line	:	11820 HUNTERS RIDGE BLVD APT 3
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-6280
Country	:	US
Telephone Number	:	814-657-8074
Fax Number	:

Provider Business Practice Location Address
First Line	:	9239 ROUTE 6
Second Line	:
City	:	UNION CITY
State	:	PA
Zip	:	16438-9727
Country	:	US
Telephone Number	:	814-438-2020
Fax Number	:

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

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	03/17/2018

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