Individual
JEREMIE RACHUNOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3974 AMBOY RD STE 302, STATEN ISLAND, NY 10308-2414
(718) 967-1071
(718) 966-0359
Mailing address
250 E 54TH ST APT 29B, NEW YORK, NY 10022-4816
(718) 967-1071
(718) 966-0359
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
220017
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JR05372D10
BLUE CROSS BLUE SHIELD
NY
Enumeration date
08/11/2006
Last updated
01/19/2026
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