Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 26NJ00816700 | NJ |
NPI | 1063909364 |
---|---|
Provider Name | Dr. Kelly Alexandra Schoch |
First Address | Somerville, NJ 08876-3235 |
Second Address | Somerville, NJ 08876-3235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2018 |
Last Update Date | 02/08/2020 |