1679519383 NPI number — DR. RICHARD MARTIN BOCHNER M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679519383 NPI number — DR. RICHARD MARTIN BOCHNER M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

BOCHNER

Provider First Name:

RICHARD

Provider Middle Name:

MARTIN

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1679519383

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

08/01/2012

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 5200

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

MANHASSET

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

11030-5200

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

516-723-2663

Provider Business Mailing Address Fax Number:

516-325-7190

Provider First Line Business Practice Location Address:

611 NORTHERN BLVD

Provider Second Line Business Practice Location Address:

SUITE 200

Provider Business Practice Location Address City Name:

GREAT NECK

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

11021-5207

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

516-723-2663

Provider Business Practice Location Address Fax Number:

516-325-7190

Provider Enumeration Date:

06/21/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207X00000X , with the licence number:  142449 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 4278113 . This is a "AETNA PPO & TRADITIONAL" identifier . This identifiers is of the category "OTHER".
• Identifier: 2C4135 . This is a "HEALTHNET OF NE" identifier . This identifiers is of the category "OTHER".
• Identifier: 142449-8B . This is a "WORKERS' COMP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 4019250001 . This is a "MEDICARE DME" identifier . This identifiers is of the category "OTHER".
• Identifier: 0098490 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: AS715 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 00879507 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 108082200 . This is a "US DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
• Identifier: 11Q412 . This is a "EMPIRE BLUE CROSS/BLUE SH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 184423P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 200043220 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 2225433 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".