Provider Demographics
NPI:1215397781
Name:ROCHA FAMILY EYE CARE PC
Entity Type:Organization
Organization Name:ROCHA FAMILY EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-489-8868
Mailing Address - Street 1:322 E RTE 4
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-5105
Mailing Address - Country:US
Mailing Address - Phone:201-489-8868
Mailing Address - Fax:
Practice Address - Street 1:322 E RTE 4
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5105
Practice Address - Country:US
Practice Address - Phone:201-489-8868
Practice Address - Fax:201-489-9642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00663600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty