MEDICARE: RACHEL BETH DORFMAN L.AC

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	171100000X	Acupuncturist	588	CT

General Provider Information

NPI Number	:	1720739105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL BETH DORFMAN L.AC

Provider Business Mailing Address
First Line	:	351 HORSE FENCE HILL RD
Second Line	:
City	:	SOUTHBURY
State	:	CT
Zip	:	06488-4129
Country	:	US
Telephone Number	:	678-595-6853
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 MAIN ST N STE 1B
Second Line	:
City	:	WOODBURY
State	:	CT
Zip	:	06798-2966
Country	:	US
Telephone Number	:	203-266-9088
Fax Number	:

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

Provider Enumeration Date	:	01/17/2022
Last Update Date	:	01/17/2022

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