Rachael Elizabeth Gruenbaum
Individual provider Active NPI Contractor · Plain City, OH
NPI 1144928532 · NPPES record last updated Feb 16, 2023
Key facts
- NPI
- 1144928532
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 14235 Hidden Farms Rd
Plain City, OH 43064-9726 - Phone
- (614) 352-1794
- NPI assigned
- Feb 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
14235 Hidden Farms Rd
Plain City, OH 43064-9726
Mailing address
14235 Hidden Farms Rd
Plain City, OH 43064-9726
Phone (614) 352-1794
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RS133103 | Other | OH | DRIVERS LICENSE |
Other names
- Rachael Elizabeth Pelttari
Other providers in Plain City, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.