Provider Demographics
NPI:1316165053
Name:RACHLIN, SEAN (LAC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:RACHLIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 E HARTSDALE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-3572
Mailing Address - Country:US
Mailing Address - Phone:917-822-6189
Mailing Address - Fax:914-472-9321
Practice Address - Street 1:221 E HARTSDALE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-3572
Practice Address - Country:US
Practice Address - Phone:917-822-6189
Practice Address - Fax:914-472-9321
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002550171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist