Basic Information
| Provider Information | |||||||||
| NPI: | 1679519383 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOCHNER | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | MARTIN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5200 | ||||||||
| Address2: | |||||||||
| City: | MANHASSET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110305200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167232663 | ||||||||
| FaxNumber: | 5163257190 | ||||||||
| Practice Location | |||||||||
| Address1: | 611 NORTHERN BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | GREAT NECK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110215207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167232663 | ||||||||
| FaxNumber: | 5163257190 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2006 | ||||||||
| LastUpdateDate: | 08/01/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 142449 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 4278113 | 01 | AETNA PPO & TRADITIONAL | OTHER | 2C4135 | 01 | HEALTHNET OF NE | OTHER | 142449-8B | 01 | NY | WORKERS' COMP | OTHER | 4019250001 | 01 | MEDICARE DME | OTHER | 0098490 | 01 | NY | GHI PPO | OTHER | AS715 | 01 | NY | OXFORD HEALTH PLAN | OTHER | 00879507 | 05 | NY | MEDICAID | 108082200 | 01 | US DEPT OF LABOR | OTHER | 11Q412 | 01 | NY | EMPIRE BLUE CROSS/BLUE SH | OTHER | 184423P | 01 | NY | HIP | OTHER | 200043220 | 01 | RAILROAD MEDICARE | OTHER | 2225433 | 01 | AETNA HMO | OTHER |