Provider Demographics
NPI:1083676258
Name:RAUCHWERGER, ORNA (DPM)
Entity Type:Individual
Prefix:DR
First Name:ORNA
Middle Name:
Last Name:RAUCHWERGER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 SEALY DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-2419
Mailing Address - Country:US
Mailing Address - Phone:718-614-5536
Mailing Address - Fax:212-926-0487
Practice Address - Street 1:53 SEALY DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-2419
Practice Address - Country:US
Practice Address - Phone:718-614-5536
Practice Address - Fax:212-926-0487
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005888213ES0131X
NJ25MD00287400213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPH7211Medicare UPIN