Provider Demographics
NPI:1720334667
Name:RAUSCHER, ERIC JAMES (MSED)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JAMES
Last Name:RAUSCHER
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752-1011
Mailing Address - Country:US
Mailing Address - Phone:516-477-1667
Mailing Address - Fax:
Practice Address - Street 1:284 LOWELL AVE
Practice Address - Street 2:
Practice Address - City:ISLIP TERRACE
Practice Address - State:NY
Practice Address - Zip Code:11752-1011
Practice Address - Country:US
Practice Address - Phone:516-477-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist