Provider Demographics
NPI:1396169934
Name:JARROUGE, RACHEL (DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:JARROUGE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 3RD AVE
Mailing Address - Street 2:FLR 5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2167
Mailing Address - Country:US
Mailing Address - Phone:212-861-2630
Mailing Address - Fax:212-861-2685
Practice Address - Street 1:162 W 72ND ST
Practice Address - Street 2:FLR 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3300
Practice Address - Country:US
Practice Address - Phone:212-249-5332
Practice Address - Fax:212-249-9539
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037483225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist