Healthcare Provider Details

I. General information

NPI: 1962563619
Provider Name (Legal Business Name): KRISTEN BATSON SOCHA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W RIDGEWOOD AVE STE 110
PARAMUS NJ
07652-2361
US

IV. Provider business mailing address

52 ROUND HILL RD
KINNELON NJ
07405-3219
US

V. Phone/Fax

Practice location:
  • Phone: 201-258-7603
  • Fax: 201-444-9277
Mailing address:
  • Phone: 732-266-8123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMP00124400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: