Provider Demographics
NPI:1174133524
Name:TASARO, RACHEL ANN
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:TASARO
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 1:5 NELSON PL
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2514
Mailing Address - Country:US
Mailing Address - Phone:845-826-0938
Mailing Address - Fax:
Practice Address - Street 1:5 NELSON PL
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2514
Practice Address - Country:US
Practice Address - Phone:845-826-0938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00912600225X00000X
NY024348225X00000X
FLOT21026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist