Provider Demographics
NPI:1174069140
Name:SIMKINS, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SIMKINS
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 1:18 RIDGE AVE
Mailing Address - Street 2:WARRENSBURG
Mailing Address - City:WARRENSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12885-1724
Mailing Address - Country:US
Mailing Address - Phone:518-812-4307
Mailing Address - Fax:
Practice Address - Street 1:5010 STATE HIGHWAY 30
Practice Address - Street 2:SUITE G03
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7532
Practice Address - Country:US
Practice Address - Phone:518-841-3406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0033492255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer