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General NPI Number Information
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NPI Number | 1174022347
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Entity Type | Individual
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Provider Name | BRUCE A HOCHSTADT MD
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Gender | Male
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 02/02/2018
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Provider Practice Location Address
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Address Line | 2 TOWER CENTER BLVD STE 1101G
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1100
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Country | US
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Telephone | 646-668-4507
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Fax |
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Provider Business Mailing Address
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Address Line | 100 LAKEWOOD PL
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-5010
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Country | US
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Telephone | 847-433-8442
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 30185
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License Number State | CT
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