Individual
JACQUELINE RAUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-5827
Mailing address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-5827
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0102204738
VA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
317223
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2014
Last updated
06/16/2022
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