Healthcare Provider Details

I. General information

NPI: 1053918904
Provider Name (Legal Business Name): ORANGE MEDICAL ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MIDWAY PARK DRIVE
MIDDLETOWN NY
10940
US

IV. Provider business mailing address

400 MIDWAY PARK DRIVE
MIDDLETOWN NY
10940
US

V. Phone/Fax

Practice location:
  • Phone: 845-343-0728
  • Fax: 845-343-2087
Mailing address:
  • Phone: 845-343-0728
  • Fax: 845-343-2087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOANNA BARBARA BOCHENEK
Title or Position: PARTNER
Credential: MD
Phone: 845-343-0728