Provider Demographics
NPI:1992345003
Name:TRUONG, RACHEL (PT, DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:BUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:555 SAINT JOSEPHS BLVD
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3223
Mailing Address - Country:US
Mailing Address - Phone:607-737-7804
Mailing Address - Fax:
Practice Address - Street 1:1210 150TH ST
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1748
Practice Address - Country:US
Practice Address - Phone:718-728-8476
Practice Address - Fax:718-747-6675
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0450852251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics