Provider Demographics
NPI:1083439426
Name:KELLER, RACHEL ZAHAVA (MS CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ZAHAVA
Last Name:KELLER
Suffix:
Gender:F
Credentials:MS CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14440 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2402
Mailing Address - Country:US
Mailing Address - Phone:516-233-0118
Mailing Address - Fax:
Practice Address - Street 1:104 W 29TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5310
Practice Address - Country:US
Practice Address - Phone:212-616-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035020235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist