Provider Demographics
NPI:1942367867
Name:ROCHETTI, WILLIAM PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PAUL
Last Name:ROCHETTI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-5528
Mailing Address - Country:US
Mailing Address - Phone:856-663-2040
Mailing Address - Fax:856-665-5625
Practice Address - Street 1:7740 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-5528
Practice Address - Country:US
Practice Address - Phone:856-663-2040
Practice Address - Fax:856-665-5625
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4262152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4613601Medicaid