Provider Demographics
NPI:1083676258
Name:RAUCHWERGER, ORNA (DPM)
Entity type:Individual
Prefix:DR
First Name:ORNA
Middle Name:
Last Name:RAUCHWERGER
Suffix:
Gender:
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 1:165 N VILLAGE AVE STE 107
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3701
Practice Address - Country:US
Practice Address - Phone:516-459-0705
Practice Address - Fax:516-531-8542
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005888213E00000X, 213ES0131X
NJ25MD00287400213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPH7211Medicare UPIN