Healthcare Provider Details

I. General information

NPI: 1770535064
Provider Name (Legal Business Name): VIPIN OHRI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 BROOKLYN ST
WARSAW NY
14569-1413
US

IV. Provider business mailing address

161 BROOKLYN ST
WARSAW NY
14569-1413
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-3106
  • Fax:
Mailing address:
  • Phone: 585-786-2005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number148370
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: