Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | X006471 | NY |
NPI | 1225241987 |
---|---|
Provider Name | Dr. Marc Bochner |
First Address | New York, NY 10022-4148 |
Second Address | New York, NY 10022-4148 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |