Provider Demographics
NPI:1104995935
Name:ISRAEL, RACHAEL J (PT, DPT)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:J
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 CROMWELL BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21286-3318
Mailing Address - Country:US
Mailing Address - Phone:410-583-1515
Mailing Address - Fax:410-583-9670
Practice Address - Street 1:7000 TUDSBURY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2675
Practice Address - Country:US
Practice Address - Phone:410-298-7000
Practice Address - Fax:410-448-7366
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist