Provider Demographics
NPI:1447487269
Name:POLISH, RACHEL ANN (DO)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:POLISH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:210 YORKTOWN PLZ
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1424
Mailing Address - Country:US
Mailing Address - Phone:215-600-4590
Mailing Address - Fax:
Practice Address - Street 1:2700 CLEMENS RD FL 2
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-4202
Practice Address - Country:US
Practice Address - Phone:215-607-7256
Practice Address - Fax:215-258-8999
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30125366OtherKEYSTONE MERCY
PA3881614000OtherKEYSTONE IBC
PA2709761OtherHIGHMARK BLUE SHIELD
PA1027206020001Medicaid
PA30125366OtherKEYSTONE MERCY