Rachel Ellenbogen, PA-C
Physician Assistant in Reston, VA. Individual provider (NPI-1).
NPI number1669974101
StatusActive
Last updated in NPPESFeb 3, 2020
Details
- NPI
- 1669974101
- Entity type
- Individual (NPI-1)
- Name
- Rachel Ellenbogen
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 28, 2018
- Certification date
- Feb 3, 2020
- Last updated
- Feb 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
1850 Town Center PkwyReston, VA 20190-3204
Phone 703-689-9000
Mailing address
1850 Town Center PkwyReston, VA 20190-3204
Other practice locations
400 W 16th St
Pueblo, CO 81003-2745
Pueblo, CO 81003-2745
Phone 719-584-4000
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All 83 Physician Assistant providers in Reston · All 2,193 providers in Reston
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