Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 011667 | NY |
NPI | 1649406984 |
---|---|
Provider Name | Ms. Rachel Marie Berenbaum |
First Address | New York, NY 10022-1236 |
Second Address | New York, NY 10022-1236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2009 |
Last Update Date | 01/06/2009 |