Healthcare Provider Details

I. General information

NPI: 1861568701
Provider Name (Legal Business Name): ALLAN H BAHORIC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 07/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 1RST AVE. BELLEVUE HOSPITAL
NEW YORK NY
10016
US

IV. Provider business mailing address

250 E 87TH ST 19A
NEW YORK NY
10128-3115
US

V. Phone/Fax

Practice location:
  • Phone: 212-562-1686
  • Fax: 212-562-1665
Mailing address:
  • Phone: 212-427-3999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number156780
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number156780
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: