1568465516 NPI number — RAWN SALENGER M.D.

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	SALENGER
Provider First Name	:	RAWN
Provider Middle Name	:
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Provider Name Suffix Text	:
Provider Credential Text	:	M.D.
Provider Gender Code	:	M

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NPI Number	:	1568465516
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	07/24/2007
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Provider First Line Business Mailing Address	:	255 LAFAYETTE AVE
Provider Second Line Business Mailing Address	:
Provider Business Mailing Address City Name	:	SUFFERN
Provider Business Mailing Address State Name	:	NY
Provider Business Mailing Address Postal Code	:	109014812
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	8453688800
Provider Business Mailing Address Fax Number	:	8453685608

Provider First Line Business Practice Location Address	:	255 LAFAYETTE AVE
Provider Second Line Business Practice Location Address	:
Provider Business Practice Location Address City Name	:	SUFFERN
Provider Business Practice Location Address State Name	:	NY
Provider Business Practice Location Address Postal Code	:	109014812
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	8453688800
Provider Business Practice Location Address Fax Number	:	8453685608
Provider Enumeration Date	:	05/23/2005

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• Taxonomy code: 208G00000X , with the licence number:  212244 , registered in the state of MA .
• Taxonomy code: 208G00000X , with the licence number: 232808 , registered in the state of NY .