Healthcare Provider Details

I. General information

NPI: 1134148810
Provider Name (Legal Business Name): ANDREW J ROCHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PEBBLE HILL DR SUITE 205
NORTHPORT NY
11768-1353
US

IV. Provider business mailing address

5 PEBBLE HILL DR
NORTHPORT NY
11768-1353
US

V. Phone/Fax

Practice location:
  • Phone: 516-521-9937
  • Fax: 516-521-9937
Mailing address:
  • Phone: 561-521-9937
  • Fax: 516-521-9937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number161970
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number161970
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: