Healthcare Provider Details

I. General information

NPI: 1083676258
Provider Name (Legal Business Name): ORNA RAUCHWERGER D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 N VILLAGE AVE STE 107
ROCKVILLE CENTRE NY
11570-3701
US

IV. Provider business mailing address

53 SEALY DR
LAWRENCE NY
11559-2419
US

V. Phone/Fax

Practice location:
  • Phone: 516-459-0705
  • Fax: 516-531-8542
Mailing address:
  • Phone: 718-614-5536
  • Fax: 212-926-0487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN005888
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number25MD00287400
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN005888
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: