Basic Information
Provider Information
NPI: 1154449759
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOCH
FirstName: DEBORAH
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: DNP/ACND-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 301 US ROUTE 1
Address2: BUILDING C
City: SCARBOROUGH
State: ME
PostalCode: 040749701
CountryCode: US
TelephoneNumber: 2073968600
FaxNumber: 2073968632
Practice Location
Address1: 19 WEST ST
Address2:  
City: PORTLAND
State: ME
PostalCode: 041023405
CountryCode: US
TelephoneNumber: 2078427180
FaxNumber: 2078427190
Other Information
ProviderEnumerationDate: 03/26/2007
LastUpdateDate: 03/10/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XR044225MEY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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