Provider Demographics
NPI:1477867562
Name:RICHARD M. BACHRACH D.O., P.C.
Entity Type:Organization
Organization Name:RICHARD M. BACHRACH D.O., P.C.
Other - Org Name:CENTER FOR SPORTS AND OSTEOPATHIC MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:ISTVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-685-8113
Mailing Address - Street 1:317 MADISON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5201
Mailing Address - Country:US
Mailing Address - Phone:212-685-8113
Mailing Address - Fax:212-697-4541
Practice Address - Street 1:317 MADISON AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5201
Practice Address - Country:US
Practice Address - Phone:212-685-8113
Practice Address - Fax:212-697-4541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-30
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076496204C00000X
NJ239708207P00000X
NY1480232081S0010X
NY255844208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty