Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | R193522 | MD |
NPI | 1235432295 |
---|---|
Provider Name | Thomas John Rauchut |
First Address | Coatesville, PA 19320-5619 |
Second Address | Philadelphia, PA 19134-1043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2010 |
Last Update Date | 11/02/2013 |