Provider Demographics
NPI:1174752752
Name:VICCARO, RACHAEL COLBY (PA-C)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:COLBY
Last Name:VICCARO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2020 TECHNOLOGY PKWY STE 3200
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-9426
Mailing Address - Country:US
Mailing Address - Phone:717-988-1428
Mailing Address - Fax:717-221-5562
Practice Address - Street 1:2020 TECHNOLOGY PKWY STE 3200
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9426
Practice Address - Country:US
Practice Address - Phone:717-988-1428
Practice Address - Fax:717-221-5562
Is Sole Proprietor?:No
Enumeration Date:2009-07-05
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAPA3804363A00000X
PAMA063599363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant