Healthcare Provider Details

I. General information

NPI: 1730387861
Provider Name (Legal Business Name): DR RACHEL R KUSHNER DERMATOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 FRANKLIN AVE
FRANKLIN SQUARE NY
11010-1332
US

IV. Provider business mailing address

320 FRANKLIN AVE
FRANKLIN SQUARE NY
11010-1332
US

V. Phone/Fax

Practice location:
  • Phone: 516-328-6252
  • Fax: 516-328-6254
Mailing address:
  • Phone: 516-328-6252
  • Fax: 516-328-6254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RACHEL R KUSHNER
Title or Position: PHYSICIAN
Credential: DO
Phone: 516-328-6252