# AGEONICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396020145
- **Authorized official:** JEREMIE RACHUNOW M.D. (OFFICER)
- **Authorized official phone:** (212) 510-7020

## Contact information

- **Practice address:** 109 E 36TH ST, NEW YORK, NY 10016-3447
- **Practice address phone:** (212) 510-7020
- **Practice address fax:** (212) 510-7021
- **Mailing address:** 109 E 36TH ST, NEW YORK, NY 10016-3447
- **Mailing address phone:** (212) 510-7020
- **Mailing address fax:** (212) 510-7021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X010496-1 | NY | — |
| 207Q00000X | Family Medicine Physician | 220017-1 | NY | Yes |

## Other

- **Enumeration date:** 10/12/2011
- **Last updated:** 10/12/2011