Provider Demographics
NPI:1598700247
Name:RICHARD M. BOCHNER, M.D., P.C.
Entity Type:Organization
Organization Name:RICHARD M. BOCHNER, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:BOCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-352-0737
Mailing Address - Street 1:PO BOX 843279
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-3279
Mailing Address - Country:US
Mailing Address - Phone:516-352-0737
Mailing Address - Fax:516-352-0819
Practice Address - Street 1:2500 MARCUS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042-1018
Practice Address - Country:US
Practice Address - Phone:516-352-0737
Practice Address - Fax:516-352-0819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142449207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2225433OtherAETNA HMO
4278113OtherAETNA PPO & TRADITIONAL
0098490OtherGHI PPO
NY11Q412OtherEMPIRE BC/BS
108082200OtherUS DEPT OF LABOR
AS715OtherOXFORD HEALTH PLAN
184423POtherHIP
NY142449-8BOtherWORKERS' COMP
NY2C4135OtherHEALTHNET OF NE
2225433OtherAETNA HMO
NY2C4135OtherHEALTHNET OF NE