Provider Demographics
NPI:1285761627
Name:BACHENHEIMER, RONDA M (CH)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:M
Last Name:BACHENHEIMER
Suffix:
Gender:F
Credentials:CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2296 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2029
Mailing Address - Country:US
Mailing Address - Phone:516-579-9300
Mailing Address - Fax:
Practice Address - Street 1:2296 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2029
Practice Address - Country:US
Practice Address - Phone:516-579-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004440-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY112773902OtherTAX ID
NY112773902OtherTAX ID