Provider Demographics
NPI:1043251903
Name:OCAMPOS, DEOLINDO (MD)
Entity type:Individual
Prefix:DR
First Name:DEOLINDO
Middle Name:
Last Name:OCAMPOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 HAWTHORNE CT
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1912
Mailing Address - Country:US
Mailing Address - Phone:716-662-5458
Mailing Address - Fax:
Practice Address - Street 1:310 STERLING DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1569
Practice Address - Country:US
Practice Address - Phone:716-677-6800
Practice Address - Fax:716-634-1930
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117719207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00591662Medicaid
NYB71506Medicare UPIN
NY00591662Medicaid