Provider Demographics
NPI:1831533660
Name:BRUMBERGER, RACHEL LEAH COHEN (LAC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEAH COHEN
Last Name:BRUMBERGER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 COURTS WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2276
Mailing Address - Country:US
Mailing Address - Phone:301-706-3884
Mailing Address - Fax:
Practice Address - Street 1:8955 GUILFORD RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2651
Practice Address - Country:US
Practice Address - Phone:443-393-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02060171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist