Individual
RACHEL COLVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
30 HATFIELD LN, SUITE 208, GOSHEN, NY 10924-6766
(845) 294-0994
(845) 615-1376
Mailing address
2 COATES DR, GOSHEN, NY 10924-6758
(845) 651-1400
(845) 651-1512
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
209161
NY
207RN0300X
Nephrology Physician
Primary
209161
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02154387
—
NY
05
—
48101
—
NJ
01
—
A400001726
MEDICARE
—
Enumeration date
10/06/2005
Last updated
09/27/2012
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