Provider Demographics
NPI:1053963066
Name:BEITLER, RACHEL MAE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MAE
Last Name:BEITLER
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 1:229 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5687
Mailing Address - Country:US
Mailing Address - Phone:847-220-1621
Mailing Address - Fax:
Practice Address - Street 1:329 E 62ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7769
Practice Address - Country:US
Practice Address - Phone:847-220-1621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker