Provider Demographics
NPI:1477722098
Name:MCPEAK-LAROCCA, PATRICIA (CNM)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MCPEAK-LAROCCA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SYCAMORE AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1228
Mailing Address - Country:US
Mailing Address - Phone:732-747-9310
Mailing Address - Fax:732-747-9320
Practice Address - Street 1:34 SYCAMORE AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1228
Practice Address - Country:US
Practice Address - Phone:732-747-9310
Practice Address - Fax:732-747-9320
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00033001367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife