Provider Demographics
NPI:1801828199
Name:HOCHBERG, ERIC M (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:HOCHBERG
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 1:10 MEDICAL PLAZA
Mailing Address - Street 2:SUITE 206
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2169
Mailing Address - Country:US
Mailing Address - Phone:516-676-2270
Mailing Address - Fax:516-676-5498
Practice Address - Street 1:10 MEDICAL PLAZA
Practice Address - Street 2:SUITE 206
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2169
Practice Address - Country:US
Practice Address - Phone:516-676-2270
Practice Address - Fax:516-676-5498
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170141208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA5189OtherOXFORD
NY17935OtherVYTRA
NY29342POtherHIP
NY01508378Medicaid
NY17935OtherVYTRA
NY01508378Medicaid