Individual
RACHEL MARIE TERLECKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1320 WEST MAIN ST, NEWARK, OH 43055
(220) 564-4151
(220) 564-7153
Mailing address
1320 WEST MAIN ST, NEWARK, OH 43055
(220) 564-4151
(220) 564-7153
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34.010374
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073311
—
OH
01
—
H122920
MEDICARE PTAN
OH
01
—
H122921
MEDICARE PTAN
OH
Enumeration date
06/04/2010
Last updated
01/30/2017
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