Provider Demographics
NPI:1609937655
Name:ROCA-PICCINI, ELSIE
Entity Type:Individual
Prefix:
First Name:ELSIE
Middle Name:
Last Name:ROCA-PICCINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 GEORGE ST
Mailing Address - Street 2:UNIVERSITY MEDICAL GROUP 3RD FLOOR
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2008
Mailing Address - Country:US
Mailing Address - Phone:732-235-8282
Mailing Address - Fax:
Practice Address - Street 1:1 WORLDS FAIR DR
Practice Address - Street 2:ROBERT WOOD JOHNSON UNIVERSITY MEDICAL GROUP - SOMERSET
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1344
Practice Address - Country:US
Practice Address - Phone:732-743-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA68300208000000X
NJ25MA06830000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8238804Medicaid
NJ038266DGEMedicare PIN
NJ8238804Medicaid