Provider Demographics
NPI:1629285325
Name:SOCOTCH, TINA MAY (MS)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MAY
Last Name:SOCOTCH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:TINA
Other - Middle Name:MAY SOCOTCH
Other - Last Name:JESSUP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:400 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1819
Mailing Address - Country:US
Mailing Address - Phone:215-757-5913
Mailing Address - Fax:215-750-7349
Practice Address - Street 1:400 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1819
Practice Address - Country:US
Practice Address - Phone:215-757-5913
Practice Address - Fax:215-750-7349
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00064700231H00000X
PAAT005905237600000X
NJ25MG00099900237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter