Provider Demographics
NPI:1043741986
Name:SARGENT, RACHEL ELISE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELISE
Last Name:SARGENT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6740 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5350
Mailing Address - Country:US
Mailing Address - Phone:929-455-2770
Mailing Address - Fax:929-455-2748
Practice Address - Street 1:6740 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5350
Practice Address - Country:US
Practice Address - Phone:929-455-2770
Practice Address - Fax:929-455-2748
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322640208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery