MEDICARE: ROSS LOUIS NOCHIMSON D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	5101018041	MI
2	208VP0014X	Interventional Pain Medicine Physician	MB068037	NJ
3	208VP0014X	Interventional Pain Medicine Physician	214784-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154324234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSS LOUIS NOCHIMSON D.O.

Provider Business Mailing Address
First Line	:	PO BOX 2756
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07015-2756
Country	:	US
Telephone Number	:	973-219-6516
Fax Number	:	877-936-7158

Provider Business Practice Location Address
First Line	:	1187 MAIN AVE STE 3F
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07011-2252
Country	:	US
Telephone Number	:	973-600-5687
Fax Number	:	877-775-3167

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/12/2024

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