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NPI Code Detail

MEDICARE: MRS. RACHELLE FREEDMAN RENOV OTR/L

MEDICARE: MRS. RACHELLE FREEDMAN RENOV OTR/L
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
1225X00000XOccupational TherapistP83414NY

General Provider Information

NPI Number : 1720354129
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RACHELLE FREEDMAN RENOV OTR/L
Provider Business Mailing Address
First Line : 3321 AVENUE M
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-5421
Country : US
Telephone Number : 718-531-1800
Fax Number :
Provider Business Practice Location Address
First Line : 3321 AVENUE M
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-5421
Country : US
Telephone Number : 718-531-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2012
Last Update Date : 04/05/2012

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