Basic Information
| Provider Information | |||||||||
| NPI: | 1245749738 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OCAMPO | ||||||||
| FirstName: | ALLAN ALDRICH | ||||||||
| MiddleName: | JAMORA | ||||||||
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| Credential: | FNP, PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 107 INSTITUTE ST | ||||||||
| Address2: | |||||||||
| City: | JAMESTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147016628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7164844334 | ||||||||
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| Practice Location | |||||||||
| Address1: | 75 E 3RD ST | ||||||||
| Address2: | |||||||||
| City: | DUNKIRK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140482239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163636050 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2017 | ||||||||
| LastUpdateDate: | 06/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 2017033627 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LP0808X | F403292-01 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.