Provider Demographics
NPI:1962563619
Name:SOCHA, KRISTEN BATSON (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:BATSON
Last Name:SOCHA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 ROUND HILL RD
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-3219
Mailing Address - Country:US
Mailing Address - Phone:732-266-8123
Mailing Address - Fax:
Practice Address - Street 1:1 W RIDGEWOOD AVE STE 110
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2361
Practice Address - Country:US
Practice Address - Phone:201-258-7603
Practice Address - Fax:201-444-9277
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMP00124400363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJQ26916Medicare UPIN
NJ016227UA1Medicare PIN
NJ174414UA1Medicare PIN