Provider Demographics
NPI:1932299716
Name:ROKOS, JAMES (SPSYS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:ROKOS
Suffix:
Gender:M
Credentials:SPSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 SCOTT LN
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6845
Mailing Address - Country:US
Mailing Address - Phone:610-872-2388
Mailing Address - Fax:610-872-0378
Practice Address - Street 1:511 SCOTT LN
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:PA
Practice Address - Zip Code:19086-6845
Practice Address - Country:US
Practice Address - Phone:610-872-2388
Practice Address - Fax:610-872-0378
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-003479-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA403745OtherBLUE SHIELD PROVIDER NO.