Organization
AGEONICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMIE RACHUNOW M.D. (OFFICER)
(212) 510-7020
Entity
Organization
Contact information
Practice address
109 E 36TH ST, NEW YORK, NY 10016-3447
(212) 510-7020
(212) 510-7021
Mailing address
109 E 36TH ST, NEW YORK, NY 10016-3447
(212) 510-7020
(212) 510-7021
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
X010496-1
NY
207Q00000X
Family Medicine Physician
Primary
220017-1
NY
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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