Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 2010015154 | MO |
N | 207V00000X | Obstetrician & Gynecologist | 50091 | MN |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 50091 | MN |
N | 207VG0400X | Gynecologist | 108036 | MN |
NPI | 1043421860 |
---|---|
Provider Name | John A Occhino |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 19/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I74372 | (02) |