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General NPI Number Information
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NPI Number | 1134214448
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Entity Type | Organization
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Legal Business Name | JORDAN W RACHLIN DPM PC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 05/22/2009
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Provider Practice Location Address
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Address Line | 221 E HARTSDALE AVE
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City | HARTSDALE
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State | NY
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Zip | 10530-3572
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Country | US
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Telephone | 914-472-9272
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Fax | 914-472-9321
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Provider Business Mailing Address
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Address Line | 221 E HARTSDALE AVE
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City | HARTSDALE
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State | NY
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Zip | 10530-3572
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Country | US
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Telephone | 914-472-9272
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Fax | 914-472-9321
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Authorized Official
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Title or Position | PRES
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Name | DR. JORDAN W RACHLIN
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Credential | DPM
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Telephone | 914-472-9272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 002464
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License Number State | NY
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