Provider Demographics
NPI:1366996407
Name:CIOTA, RACHEL LISE (FNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LISE
Last Name:CIOTA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 CENTER BLVD APT 2111
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11109-5882
Mailing Address - Country:US
Mailing Address - Phone:631-456-1130
Mailing Address - Fax:718-684-5266
Practice Address - Street 1:4610 CENTER BLVD APT 2111
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11109-5882
Practice Address - Country:US
Practice Address - Phone:631-456-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345263363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily