Individual
RACHEL CAROLINE BROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2976 US-9W, SAUGERTIES, NY 12477
(518) 264-9000
Mailing address
46 PREUSSER RD, CRARYVILLE, NY 12521-5259
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
021754
NY
Other
Enumeration date
01/25/2018
Last updated
09/17/2019
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