Basic Information
| Provider Information | |||||||||
| NPI: | 1912130105 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOCBO | ||||||||
| FirstName: | AILEEN | ||||||||
| MiddleName: | BOA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1925 PACIFIC AVE | ||||||||
| Address2: | |||||||||
| City: | ATLANTIC CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 084016713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094418146 | ||||||||
| FaxNumber: | 6094418002 | ||||||||
| Practice Location | |||||||||
| Address1: | 1925 PACIFIC AVE | ||||||||
| Address2: | |||||||||
| City: | ATLANTIC CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 084016713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094418146 | ||||||||
| FaxNumber: | 6094418002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2009 | ||||||||
| LastUpdateDate: | 04/09/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MA08801800 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 25MA08801800 | NJ | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.