Provider Demographics
NPI:1306312038
Name:TELFORT, RACHEL (FNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:TELFORT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 EASTERN PKWY FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-1604
Mailing Address - Country:US
Mailing Address - Phone:347-773-1100
Mailing Address - Fax:
Practice Address - Street 1:546 EASTERN PKWY FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-1604
Practice Address - Country:US
Practice Address - Phone:347-773-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-20
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF342324363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily