Basic Information
| Provider Information | |||||||||
| NPI: | 1427405984 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMALDONE | ||||||||
| FirstName: | RACHEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 343 4TH AVE | ||||||||
| Address2: | APT 3E | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112152719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9178340573 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 1ST AVE | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100166402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122637300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2016 | ||||||||
| LastUpdateDate: | 05/15/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 22 590436 | NY | N | Nursing Service Providers | Registered Nurse | 363LA2200X | 30 306586 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.