Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD458546 | PA |
NPI | 1740507185 |
---|---|
Provider Name | Rachel Shakked |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Willow Grove, PA 19090-1700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2010 |
Last Update Date | 21/07/2016 |