Provider Demographics
NPI:1093752263
Name:RAUSCH, JOHN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:RAUSCH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3959 BROADWAY
Mailing Address - Street 2:COLUMBIA UNVERSITY DEPARTMENT PEDIATRIC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1559
Mailing Address - Country:US
Mailing Address - Phone:212-304-7297
Mailing Address - Fax:212-544-1974
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:COLUMBIA UNVERSITY DEPARTMENT PEDIATRIC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:212-304-7250
Practice Address - Fax:212-544-1974
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2019-10-18
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Provider Licenses
StateLicense IDTaxonomies
NY2322412083B0002X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02779308Medicaid
NY02779308Medicaid
NYI54189Medicare UPIN