Provider Demographics
NPI:1861551368
Name:OCHRYM MEDICAL
Entity type:Organization
Organization Name:OCHRYM MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:OCHRYM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-877-7216
Mailing Address - Street 1:3048 RT 22
Mailing Address - Street 2:
Mailing Address - City:DOWER PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12522
Mailing Address - Country:US
Mailing Address - Phone:845-877-7216
Mailing Address - Fax:845-877-4635
Practice Address - Street 1:3048 RT 22
Practice Address - Street 2:
Practice Address - City:DOWER PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12522
Practice Address - Country:US
Practice Address - Phone:845-877-7216
Practice Address - Fax:845-877-4635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BO3846245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F69295Medicare UPIN
17H841Medicare ID - Type Unspecified