Basic Information
Provider Information
NPI: 1891220992
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAVEL
FirstName: RACHEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.P.T.
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 95 UNIVERSITY PL
Address2: FL 8
City: NEW YORK
State: NY
PostalCode: 100034515
CountryCode: US
TelephoneNumber: 2126041316
FaxNumber: 2126041320
Practice Location
Address1: 409 FULTON ST
Address2: 2ND FLOOR
City: BROOKLYN
State: NY
PostalCode: 112015103
CountryCode: US
TelephoneNumber: 7182601000
FaxNumber: 7182600072
Other Information
ProviderEnumerationDate: 04/26/2017
LastUpdateDate: 03/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X041041-1NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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