Basic Information
Provider Information
NPI: 1194795161
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOCH-ESPADA
FirstName: AMY
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: PSY.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HOCH
OtherFirstName: AMY
OtherMiddleName: L
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 635
Address2:  
City: BELLMAWR
State: NJ
PostalCode: 080990635
CountryCode: US
TelephoneNumber: 8565666706
FaxNumber: 8565666108
Practice Location
Address1: 42 LAUREL RD E
Address2: UDP #1100
City: STRATFORD
State: NJ
PostalCode: 080841354
CountryCode: US
TelephoneNumber: 8565667036
FaxNumber: 8565666108
Other Information
ProviderEnumerationDate: 01/24/2006
LastUpdateDate: 11/11/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000XSI00374400NJY Behavioral Health & Social Service ProvidersPsychologist 

ID Information
IDTypeStateIssuerDescription
842970705NJ MEDICAID


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