Provider Demographics
NPI:1639388283
Name:LAROCCA, AMY LYNN (RN, APN-C)
Entity Type:Individual
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First Name:AMY
Middle Name:LYNN
Last Name:LAROCCA
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Gender:F
Credentials:RN, APN-C
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Mailing Address - Street 1:2 CENTRE PLAZA
Mailing Address - Street 2:CENTRAL JERSEY REHABILITATION MEDICINE, LLC
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724
Mailing Address - Country:US
Mailing Address - Phone:732-460-5360
Mailing Address - Fax:732-460-7442
Practice Address - Street 1:2 CENTRE PLAZA
Practice Address - Street 2:CENTRAL JERSEY REHABILITATION MEDICINE, LLC
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724
Practice Address - Country:US
Practice Address - Phone:732-460-5360
Practice Address - Fax:732-460-7442
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2009-01-28
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00079600363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092110Medicare ID - Type Unspecified