Basic Information
| Provider Information | |||||||||
| NPI: | 1346521820 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TODD ALVIN ROCHMAN MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 633 GIDNEY AVE | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | NEWBURGH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125502800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455692900 | ||||||||
| FaxNumber: | 8455692901 | ||||||||
| Practice Location | |||||||||
| Address1: | 633 GIDNEY AVE | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | NEWBURGH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125502800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455692900 | ||||||||
| FaxNumber: | 8455692901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2011 | ||||||||
| LastUpdateDate: | 09/21/2011 | ||||||||
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| AuthorizedOfficialLastName: | SULLIVAN | ||||||||
| AuthorizedOfficialFirstName: | ERIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9148052547 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 168332 | NY | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 2084P0800X | 168332 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.