Basic Information
| Provider Information | |||||||||
| NPI: | 1447307939 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAUCH | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 57 IRA RD | ||||||||
| Address2: | SUITE 156 | ||||||||
| City: | SYOSSET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117913504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167292629 | ||||||||
| FaxNumber: | 7187330351 | ||||||||
| Practice Location | |||||||||
| Address1: | 4708 104TH ST | ||||||||
| Address2: | |||||||||
| City: | CORONA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113682811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187257417 | ||||||||
| FaxNumber: | 7184767234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 008315 | NY | Y | Chiropractic Providers | Chiropractor |
No ID Information.