Provider Demographics
NPI:1740481407
Name:NOCHUMSON, JOSHUA ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ALAN
Last Name:NOCHUMSON
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 1:50 MOISEY DR STE 214
Mailing Address - Street 2:
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-9297
Mailing Address - Country:US
Mailing Address - Phone:570-501-6900
Mailing Address - Fax:570-501-6945
Practice Address - Street 1:2226 BLAKESLEE BOULEVARD DR E STE 200
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-9619
Practice Address - Country:US
Practice Address - Phone:610-691-8074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA86703208C00000X
PAMD462483208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0221511Medicaid
NJP00864742OtherRR MEDICARE
PA1033668Medicaid
NJ1366461OtherGHI
TXBP20020252Medicare UPIN