MEDICARE: ROCKWELL MEDICAL PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RO0S32G610	OTHER	NY	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1649209727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKWELL MEDICAL PC

Provider Business Mailing Address
First Line	:	120 E 36TH ST STE 1E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-3423
Country	:	US
Telephone Number	:	917-447-0840
Fax Number	:	212-532-6666

Provider Business Practice Location Address
First Line	:	120 E 36TH ST STE 1E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-3423
Country	:	US
Telephone Number	:	917-447-0840
Fax Number	:	212-532-6666

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MS. JEREMIE RACHUNOW
Credential	:
Telephone Number	:	917-447-0840

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	07/31/2024

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Directions to “ROCKWELL MEDICAL PC ” Practice Location

Language	Start Address	Practice Location

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