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NPI Code Detail

MEDICARE: RACHAEL PHELPS M.D.

MEDICARE: RACHAEL PHELPS M.D.
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
1208000000XPediatrics Physician217883NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427144534
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHAEL PHELPS M.D.
Provider Business Mailing Address
First Line : 114 UNIVERSITY AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2929
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 114 UNIVERSITY AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2929
Country : US
Telephone Number : 585-546-2595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 12/16/2015

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