Individual
MRS. RACHAEL ELIZABETH STAUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
160 ROBBINS ST, WATERBURY, CT 06708-2652
(203) 573-7284
Mailing address
7 VERMONT DRIVE, LAKE SUCCESS, NY 11042
(516) 210-8400
(516) 210-8494
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
017874
NY
363AS0400X
Surgical Physician Assistant
017874
NY
363AS0400X
Surgical Physician Assistant
Primary
3430
CT
Other
Enumeration date
10/15/2014
Last updated
07/07/2021
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