Provider Demographics
NPI:1689660011
Name:OCHSNER, GREGORY J (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:OCHSNER
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:PO BOX 30560
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90030-0560
Mailing Address - Country:US
Mailing Address - Phone:610-524-5550
Mailing Address - Fax:610-524-5550
Practice Address - Street 1:470 JOHN YOUNG WAY
Practice Address - Street 2:SUITE 400
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2557
Practice Address - Country:US
Practice Address - Phone:610-524-5550
Practice Address - Fax:610-524-5546
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055074L2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015159180008Medicaid
PA0151591800010Medicaid
PA920005184OtherRR MEDICARE
PA633379M84Medicare PIN
PA0151591800010Medicaid
PA633379L2YMedicare PIN