Provider Demographics
NPI:1386371599
Name:OCHNER, SPENCER LOUIS (PA-C)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:LOUIS
Last Name:OCHNER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 RAMAPO RD
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1307
Mailing Address - Country:US
Mailing Address - Phone:973-809-9084
Mailing Address - Fax:
Practice Address - Street 1:266 HARRISTOWN RD STE 305
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-3321
Practice Address - Country:US
Practice Address - Phone:201-475-9421
Practice Address - Fax:201-475-1555
Is Sole Proprietor?:No
Enumeration Date:2022-08-07
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00716600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant