Provider Demographics
NPI:1609958313
Name:ROCA, JAVIER A (MD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:A
Last Name:ROCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:176-60 UNION TURNPIKE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366
Mailing Address - Country:US
Mailing Address - Phone:718-460-2300
Mailing Address - Fax:718-460-9697
Practice Address - Street 1:176-60 UNION TURNPIKE
Practice Address - Street 2:SUITE 360
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366
Practice Address - Country:US
Practice Address - Phone:718-460-2300
Practice Address - Fax:718-460-9697
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY184568-1174400000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01523413Medicaid
NY01523413Medicaid
NYF84840Medicare UPIN