Healthcare Provider Details
I. General information
NPI: 1861551368
Provider Name (Legal Business Name): OCHRYM MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3048 RT 22
DOWER PLAINS NY
12522
US
IV. Provider business mailing address
3048 RT 22
DOWER PLAINS NY
12522
US
V. Phone/Fax
- Phone: 845-877-7216
- Fax: 845-877-4635
- Phone: 845-877-7216
- Fax: 845-877-4635
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | BO3846245 |
| License Number State | |
VIII. Authorized Official
Name: DR.
RICHARD
G
OCHRYM
Title or Position: MD OWNER
Credential: MD
Phone: 845-877-7216