Provider Demographics
NPI:1619718897
Name:RAICE, RACHEL
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:RAICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LAURA LN
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1106
Mailing Address - Country:US
Mailing Address - Phone:646-456-5310
Mailing Address - Fax:
Practice Address - Street 1:26B REUVEN STREET
Practice Address - Street 2:
Practice Address - City:BET SHEMESH
Practice Address - State:JERUSALEM
Practice Address - Zip Code:9954441
Practice Address - Country:IL
Practice Address - Phone:646-456-5310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY509240-1163WL0100X, 163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant