Basic Information
Provider Information
NPI: 1952323180
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VORCHHEIMER
FirstName: DAVID
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 GUSTAVE L LEVY PL
Address2: BOX 1030
City: NEW YORK
State: NY
PostalCode: 100296500
CountryCode: US
TelephoneNumber: 2122414258
FaxNumber: 2123607190
Practice Location
Address1: 5 E 98TH ST
Address2: 3RD FLOOR
City: NEW YORK
State: NY
PostalCode: 100296501
CountryCode: US
TelephoneNumber: 2122415586
FaxNumber: 2124107196
Other Information
ProviderEnumerationDate: 07/24/2006
LastUpdateDate: 06/02/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X175854NYN Other Service ProvidersSpecialist 
207RC0000X175854NYY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

ID Information
IDTypeStateIssuerDescription
0124451305NY MEDICAID


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