Provider Demographics
NPI:1548361835
Name:OHRI MEDICAL GROUP, PC
Entity type:Organization
Organization Name:OHRI MEDICAL GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TARUN
Authorized Official - Middle Name:K
Authorized Official - Last Name:OHRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-786-3106
Mailing Address - Street 1:165 BROOKLYN ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569-1413
Mailing Address - Country:US
Mailing Address - Phone:585-786-3106
Mailing Address - Fax:585-786-3407
Practice Address - Street 1:165 BROOKLYN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-1413
Practice Address - Country:US
Practice Address - Phone:585-786-3106
Practice Address - Fax:585-786-3407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148370207Q00000X
NY138960207RC0000X
NYF303253363LA2200X
NYF331695363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB36172Medicare UPIN