Individual
RACHAEL JEAN ROEDER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST
Contact information
Practice address
360 GRAHAM AVE, BROOKLYN, NY 11211-3709
(718) 388-1600
(718) 388-1551
Mailing address
260 AINSLIE ST, BROOKLYN, NY 11211-4914
(718) 388-1600
(718) 388-1551
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
002064-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002064-1
NEW YORK STATE LICENSE
NY
05
—
01582585
—
NY
Enumeration date
05/31/2006
Last updated
07/08/2007
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