Basic Information
| Provider Information | |||||||||
| NPI: | 1184890113 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOCHBAUM | ||||||||
| FirstName: | NATALIA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 95000-6585 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191956585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314656297 | ||||||||
| FaxNumber: | 6314656524 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 PORT WASHINGTON BLVD. | ||||||||
| Address2: | ADVANCED CARDIAC THERAPEUTICS | ||||||||
| City: | ROSLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115761347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166292090 | ||||||||
| FaxNumber: | 5166292094 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2008 | ||||||||
| LastUpdateDate: | 09/16/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 250036 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 250036 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 00684886 | 05 | NY | MEDICAID | 03039425 | 05 | NY | MEDICAID |