Provider Demographics
NPI:1629139787
Name:ROCAMORA, MELISSA VILLAMOR (PT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:VILLAMOR
Last Name:ROCAMORA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 LIBERTY ST APT 34
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-1767
Mailing Address - Country:US
Mailing Address - Phone:201-490-3787
Mailing Address - Fax:
Practice Address - Street 1:167 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LITTLE FERRY
Practice Address - State:NJ
Practice Address - Zip Code:07643-2009
Practice Address - Country:US
Practice Address - Phone:201-641-1600
Practice Address - Fax:201-807-0231
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA01030400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ096518Medicare ID - Type UnspecifiedMEDICARE PROVIDER BILLING