Provider Demographics
NPI:1366747321
Name:SIEGEL, RACHEL ANNA (MSN, CNM)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ANNA
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W 86TH ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3625
Mailing Address - Country:US
Mailing Address - Phone:212-603-4173
Mailing Address - Fax:
Practice Address - Street 1:2 W 86TH ST APT 3A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3625
Practice Address - Country:US
Practice Address - Phone:212-603-4173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001420363LX0001X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0255181Medicaid