Provider Demographics
NPI:1497836969
Name:HOCHBERGER, DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:HOCHBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PAWTUCKET AVE
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-2135
Mailing Address - Country:US
Mailing Address - Phone:401-431-6224
Mailing Address - Fax:401-431-9011
Practice Address - Street 1:400 PAWTUCKET AVE
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:RI
Practice Address - Zip Code:02916-2135
Practice Address - Country:US
Practice Address - Phone:401-431-6224
Practice Address - Fax:401-431-9011
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI066373207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1620.7OtherBC#
RI0000777540Medicaid
RI006637 PU T6OtherTUFTS
RI003971OtherBLUECHIP
RI0402735OtherUHP (UNITED HEALTH PLANS)
RIRI 6637OtherBCHOICE/LIFESPAN
RI1620.7OtherBC#
RI0402735OtherUHP (UNITED HEALTH PLANS)