Provider Demographics
NPI:1699528414
Name:ROSENTHAL-TAWIL, RACHEL D
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:D
Last Name:ROSENTHAL-TAWIL
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 1:2 HINCKLEY PL APT 2I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3370
Mailing Address - Country:US
Mailing Address - Phone:917-626-2726
Mailing Address - Fax:
Practice Address - Street 1:2 HINCKLEY PL APT 2I
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3370
Practice Address - Country:US
Practice Address - Phone:917-626-2726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3808999174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist