Basic Information
Provider Information
NPI: 1881845154
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAUCHER
FirstName: DANIEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: P.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 537
Address2:  
City: LIVINGSTON
State: NJ
PostalCode: 070390537
CountryCode: US
TelephoneNumber: 8003450064
FaxNumber:  
Practice Location
Address1: 355 BARD AVE
Address2: RICHMOND UNIVERSITY MEDICAL CENTER
City: STATEN ISLAND
State: NY
PostalCode: 103101664
CountryCode: US
TelephoneNumber: 7188181117
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/06/2008
LastUpdateDate: 10/06/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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