Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036108587 | IL |
N | 111NI0900X | Internist | 036108587 | IL |
Y | 207RG0300X | Geriatric Medicine | 236811 | MA |
N | 207RH0002X | Hospice and Palliative Medicine | 236811 | MA |
NPI | 1134145345 |
---|---|
Provider Name | Dr. Rachelle E. Bernacki |
First Address | Boston, MA 02115-0001 |
Second Address | Boston, MA 02115-6013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 22/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110080920A | (05) | MA |