MEDICARE: MS. RACHELIE GILBERT RN

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	163W00000X	Registered Nurse	670024	NY

General Provider Information

NPI Number	:	1962823245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RACHELIE GILBERT RN

Provider Business Mailing Address
First Line	:	16329 130TH AVE
Second Line	:	APT 10F
City	:	JAMAICA
State	:	NY
Zip	:	11434-3037
Country	:	US
Telephone Number	:	347-296-5455
Fax Number	:

Provider Business Practice Location Address
First Line	:	16329 130TH AVE
Second Line	:	APT 10F
City	:	JAMAICA
State	:	NY
Zip	:	11434-3037
Country	:	US
Telephone Number	:	347-296-5455
Fax Number	:

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

Provider Enumeration Date	:	01/03/2014
Last Update Date	:	01/03/2014

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