MEDICARE: RACHITA PATHAK

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	225100000X	Physical Therapist	049207	NY

General Provider Information

NPI Number	:	1932897972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHITA PATHAK

Provider Business Mailing Address
First Line	:	8746 20TH AVE # 1L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4802
Country	:	US
Telephone Number	:	718-648-0888
Fax Number	:	855-955-3899

Provider Business Practice Location Address
First Line	:	1230 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-2003
Country	:	US
Telephone Number	:	718-648-0888
Fax Number	:	855-955-3899

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

Provider Enumeration Date	:	04/27/2023
Last Update Date	:	04/27/2023

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Directions to “ RACHITA PATHAK ” Practice Location

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