Provider Demographics
NPI:1326735119
Name:ROCKS, DEREK JOHN
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:JOHN
Last Name:ROCKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5903 5TH AVE APT 212B
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-2848
Mailing Address - Country:US
Mailing Address - Phone:724-549-3918
Mailing Address - Fax:
Practice Address - Street 1:1600 W CARSON ST STE 200
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-1031
Practice Address - Country:US
Practice Address - Phone:412-391-1137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030204225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist