Doctor Name: | CHRISTINE E RACCA |
NPI Number: | 1205198801 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS ED, S.D.A. |
License Number: | 1044421 |
Business Practice Address: | 19 Silas Woods Rd Manorville, NY - 119493052 |
Business Phone Number: | 6315804005 |
Business Fax Number: | 6314711954 |
Mailing Address: | 19 Silas Woods Rd, MANORVILLE |
State: | NY |
Postal Code: | 119493052 |
Phone Number: | 6315804005 |
Fax Number: | 6314711954 |
NPI Enumeration Date: | 06/11/2012 |
NPI Last Update Date: | 06/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1044421 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |