Provider Demographics
NPI:1427016070
Name:ROCCAFORTE, JANE S (MD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:S
Last Name:ROCCAFORTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 FARNAM ST
Mailing Address - Street 2:SUITE 145
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2806
Mailing Address - Country:US
Mailing Address - Phone:402-552-2100
Mailing Address - Fax:402-552-2104
Practice Address - Street 1:4242 FARNAM ST
Practice Address - Street 2:SUITE 145
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2806
Practice Address - Country:US
Practice Address - Phone:402-552-2100
Practice Address - Fax:402-552-2104
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE17081207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47081309213Medicaid
NE470813092Medicaid
IA2913772Medicaid
SD7719070Medicaid
NE03106OtherBCBS NE
IA2913772Medicaid
NE0987981Medicare PIN
NE47081309213Medicaid