Provider Demographics
NPI:1073856258
Name:ROE LLC
Entity Type:Organization
Organization Name:ROE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:DECATALDO
Authorized Official - Suffix:
Authorized Official - Credentials:BOCP, BOCO PROS/ORTH
Authorized Official - Phone:201-873-1490
Mailing Address - Street 1:6 ALIZE DRIVE
Mailing Address - Street 2:C/O JLJ&J
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405
Mailing Address - Country:US
Mailing Address - Phone:862-266-4932
Mailing Address - Fax:973-291-4062
Practice Address - Street 1:1025 W SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-6134
Practice Address - Country:US
Practice Address - Phone:908-925-0616
Practice Address - Fax:908-925-0618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ45PO00000600335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier