Provider Demographics
NPI:1104846864
Name:MALKIEL, RACHAEL (PA)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:MALKIEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:KAPLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3011 ANZAC AVE
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3521
Mailing Address - Country:US
Mailing Address - Phone:267-287-8216
Mailing Address - Fax:
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:DEPARTMENT OF MEDICINE 2B ELKINS BUILDING
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052053363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ46876Medicare UPIN