1598700247 NPI number — RICHARD M. BOCHNER, M.D., P.C.

Table of content: (NPI 1598700247)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598700247 NPI number — RICHARD M. BOCHNER, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD M. BOCHNER, M.D., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

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 Information

NPI Number:
1598700247
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 843279
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02284-3279
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-352-0737
Provider Business Mailing Address Fax Number:
516-352-0819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 MARCUS AVE
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
LAKE SUCCESS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11042-1018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-352-0737
Provider Business Practice Location Address Fax Number:
516-352-0819
Provider Enumeration Date:
06/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOCHNER
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
MARTIN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
516-352-0737

Provider Taxonomy Codes

  • 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" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2225433 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4278113 . This is a "AETNA PPO & TRADITIONAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0098490 . This is a "GHI PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11Q412 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 108082200 . This is a "US DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: AS715 . This is a "OXFORD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 184423P . This is a "HIP" 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: 2C4135 . This is a "HEALTHNET OF NE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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