Basic Information
Provider Information
NPI: 1730430430
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OSTER
FirstName: RACHEL
MiddleName: LEIGH
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: NIEMEYER
OtherFirstName: RACHEL
OtherMiddleName: LEIGH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PT, DPT
OtherLastNameType: 1
Mailing Information
Address1: 102 IRVING ST NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 20010
CountryCode: US
TelephoneNumber: 3015406140
FaxNumber: 3015405190
Practice Location
Address1: 12140 CENTRAL AVE
Address2:  
City: MITCHELLVILLE
State: MD
PostalCode: 207211932
CountryCode: US
TelephoneNumber: 3015406140
FaxNumber: 3015405190
Other Information
ProviderEnumerationDate: 09/21/2012
LastUpdateDate: 01/15/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/15/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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