Provider Demographics
NPI:1699709501
Name:RACHLIN, SUSAN (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:RACHLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:RACHLIN KATZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 WOODS RD
Mailing Address - Street 2:UNIVERSITY IMAGING AND MEDICAL ASSC. PC
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1530
Mailing Address - Country:US
Mailing Address - Phone:914-493-8881
Mailing Address - Fax:914-493-1195
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:WMC ADVANCED PHYSICIAN SERVICES, PC
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-8881
Practice Address - Fax:914-493-1195
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1818622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01497130Medicaid
NYF87512Medicare UPIN
NYA400031756Medicare PIN