Provider Demographics
NPI:1396246245
Name:MCBRADY, RACHEL ANNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE
Last Name:MCBRADY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANNE
Other - Last Name:MCELROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:182 NORTH STREET
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021
Mailing Address - Country:US
Mailing Address - Phone:315-515-5132
Mailing Address - Fax:765-450-6664
Practice Address - Street 1:182 NORTH STREET
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021
Practice Address - Country:US
Practice Address - Phone:315-515-5132
Practice Address - Fax:765-450-6664
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017874225100000X
IN05012951A225100000X
NY044369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist