Provider Demographics
NPI:1346776077
Name:MOTZER, RACHEL SARA
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:SARA
Last Name:MOTZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E 88TH ST
Mailing Address - Street 2:APT 4E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-7722
Mailing Address - Country:US
Mailing Address - Phone:201-970-6380
Mailing Address - Fax:
Practice Address - Street 1:506 E 88TH ST
Practice Address - Street 2:APT 4E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-7722
Practice Address - Country:US
Practice Address - Phone:201-970-6380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF308164-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health