Provider Demographics
NPI:1558339614
Name:HOCHMAN, DAVID GORDON (NP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:GORDON
Last Name:HOCHMAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 COUNTY ROAD 39
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:NY
Mailing Address - Zip Code:13730-2252
Mailing Address - Country:US
Mailing Address - Phone:607-621-3826
Mailing Address - Fax:
Practice Address - Street 1:204 COUNTY ROAD 39
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:NY
Practice Address - Zip Code:13730-2252
Practice Address - Country:US
Practice Address - Phone:607-621-3826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334108363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02600604Medicaid
NYRA9308Medicare ID - Type Unspecified
NY02600604Medicaid