Healthcare Provider Details

I. General information

NPI: 1952498966
Provider Name (Legal Business Name): CYNTHIA SUE OCHI D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6144 ROUTE 25A STE 18
WADING RIVER NY
11792-2008
US

IV. Provider business mailing address

6144 ROUTE 25A STE 18
WADING RIVER NY
11792-2008
US

V. Phone/Fax

Practice location:
  • Phone: 631-821-5670
  • Fax: 631-821-5672
Mailing address:
  • Phone: 631-821-5670
  • Fax: 631-821-5672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberX004249-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: