Provider Demographics
NPI:1922545631
Name:ROCCO, CHRISTIANNA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTIANNA
Middle Name:
Last Name:ROCCO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SUMMIT AVENUE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901
Mailing Address - Country:US
Mailing Address - Phone:908-448-7772
Mailing Address - Fax:
Practice Address - Street 1:151 SUMMIT AVENUE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901
Practice Address - Country:US
Practice Address - Phone:908-448-7772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01688900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist