Provider Demographics
NPI:1033278346
Name:ROCA, JOSE E (ATC)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:E
Last Name:ROCA
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 ARMELLINO CT
Mailing Address - Street 2:
Mailing Address - City:HIGHTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-3348
Mailing Address - Country:US
Mailing Address - Phone:609-944-7634
Mailing Address - Fax:609-944-7918
Practice Address - Street 1:116 ARMELLINO CT
Practice Address - Street 2:
Practice Address - City:HIGHTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08520-3348
Practice Address - Country:US
Practice Address - Phone:609-944-7634
Practice Address - Fax:609-944-7918
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000785002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer