Provider Demographics
NPI:1407385362
Name:SIEGEL, RACHELE MARGARET (OD)
Entity type:Individual
Prefix:DR
First Name:RACHELE
Middle Name:MARGARET
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11820 HUNTERS RIDGE BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-6280
Mailing Address - Country:US
Mailing Address - Phone:814-657-8074
Mailing Address - Fax:
Practice Address - Street 1:9239 ROUTE 6
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:PA
Practice Address - Zip Code:16438-9727
Practice Address - Country:US
Practice Address - Phone:814-438-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003285152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist