Provider Demographics
NPI:1093927089
Name:ROJAS, PAULINA ELENA (MD)
Entity Type:Individual
Prefix:
First Name:PAULINA
Middle Name:ELENA
Last Name:ROJAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAULINA
Other - Middle Name:ELENA
Other - Last Name:ROJAS NOACK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:123 HOW LN
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-3653
Mailing Address - Country:US
Mailing Address - Phone:732-745-8519
Mailing Address - Fax:732-448-0007
Practice Address - Street 1:123 HOW LN
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3653
Practice Address - Country:US
Practice Address - Phone:732-745-8519
Practice Address - Fax:732-448-0007
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024853208000000X
NJ25MA09103500208000000X
ARE-6457208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1455616Medicaid
LA4K524Medicare PIN
LA1455616Medicaid
AR5AC56Medicare PIN