Healthcare Provider Details

I. General information

NPI: 1508918590
Provider Name (Legal Business Name): EAST ORANGE PSYCHIATRIC ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 02/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 STONY BROOK CT SUITE 1
NEWBURGH NY
12550-6522
US

IV. Provider business mailing address

400 STONY BROOK CT SUITE 1
NEWBURGH NY
12550-6522
US

V. Phone/Fax

Practice location:
  • Phone: 845-565-0600
  • Fax: 866-733-1910
Mailing address:
  • Phone: 845-565-0600
  • Fax: 866-733-1910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TODD ALVIN ROCHMAN
Title or Position: PRACTICE OWNER
Credential: MD
Phone: 845-565-0600