Basic Information
| Provider Information | |||||||||
| NPI: | 1003013954 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOHNING | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | HOWARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | DVM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41 MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | NEW ROCHELLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 108015319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146326525 | ||||||||
| FaxNumber: | 9146326590 | ||||||||
| Practice Location | |||||||||
| Address1: | 41 MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | NEW ROCHELLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 108015319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146326525 | ||||||||
| FaxNumber: | 9146326590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174M00000X | 0027421 | NY | Y | Other Service Providers | Veterinarian |
ID Information
| ID | Type | State | Issuer | Description | 167667301 | 01 | NY | OXFORD HEALTH PLANS | OTHER |