Provider Demographics
NPI:1104221845
Name:GEIB, RACHEL SUSAN (MA, SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:SUSAN
Last Name:GEIB
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 E 105TH ST
Mailing Address - Street 2:APT. 9
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4435
Mailing Address - Country:US
Mailing Address - Phone:252-412-7649
Mailing Address - Fax:
Practice Address - Street 1:1750 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-4612
Practice Address - Country:US
Practice Address - Phone:252-412-7649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025521-1235Z00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174400000XOther Service ProvidersSpecialist