Provider Demographics
NPI:1760861488
Name:HALE, RACHEL ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:HALE
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 1:23 LAKEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-2021
Mailing Address - Country:US
Mailing Address - Phone:845-794-2010
Mailing Address - Fax:
Practice Address - Street 1:23 LAKEWOOD AVE
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-2021
Practice Address - Country:US
Practice Address - Phone:845-794-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY835744-01163W00000X
NY002294176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse