Provider Demographics
NPI:1073218525
Name:ROQUE, FRANKLIN (DPT)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:
Last Name:ROQUE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3341
Mailing Address - Country:US
Mailing Address - Phone:201-925-0762
Mailing Address - Fax:
Practice Address - Street 1:62 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2000
Practice Address - Country:US
Practice Address - Phone:201-664-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02147400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist