Provider Demographics
NPI:1174631808
Name:ROCHET, MICHAEL ANGELO (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANGELO
Last Name:ROCHET
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:380 GUY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-1065
Mailing Address - Country:US
Mailing Address - Phone:518-841-7415
Mailing Address - Fax:518-841-7417
Practice Address - Street 1:380 GUY PARK AVE
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-1065
Practice Address - Country:US
Practice Address - Phone:518-841-7415
Practice Address - Fax:518-841-7417
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY160473207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00854742Medicaid
NYA62066Medicare UPIN
NYJ400088736Medicare PIN