Basic Information
| Provider Information | |||||||||
| NPI: | 1508845850 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAUSCHENBACH | ||||||||
| FirstName: | KENNETH | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1910 SOUTH RD | ||||||||
| Address2: | |||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126016027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454540120 | ||||||||
| FaxNumber: | 8454546080 | ||||||||
| Practice Location | |||||||||
| Address1: | 1910 SOUTH RD | ||||||||
| Address2: | |||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126016027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454540120 | ||||||||
| FaxNumber: | 8454546080 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2006 | ||||||||
| LastUpdateDate: | 09/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 213245 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 01933760 | 05 | NY | MEDICAID | 110355800 | 01 | NY | U.S. DEPT. OF LABOR | OTHER | 7418989-001 | 01 | NY | CIGNA | OTHER | 2156641 | 01 | NY | AETNA | OTHER | 5320 | 01 | NY | SIEBA | OTHER | 10033385 | 01 | NY | CDPHP | OTHER | P1278929 | 01 | NY | OXFORD FREEDOM PLAN | OTHER | 83G831 | 01 | NY | EMPIRE BC/BS | OTHER | 187700 | 01 | NY | MVP HEALTHCARE | OTHER | 100016273 | 01 | NY | AFFINITY HEALTHPLAN | OTHER | OR-0000332 | 01 | NY | SELECT PROVIDERS | OTHER | 200036796 | 01 | NY | RAIL ROAD MEDICARE | OTHER |