Provider Demographics
NPI:1326602962
Name:HOCH, SHANA
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:HOCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1440
Mailing Address - Country:US
Mailing Address - Phone:516-317-0683
Mailing Address - Fax:
Practice Address - Street 1:123 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2240
Practice Address - Country:US
Practice Address - Phone:516-317-0683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant