Provider Demographics
NPI:1356384853
Name:ROCHA, PAULA (PT)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:
Last Name:ROCHA
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 1:2350 ROUTE 63
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14572-9509
Mailing Address - Country:US
Mailing Address - Phone:585-728-3541
Mailing Address - Fax:585-728-5658
Practice Address - Street 1:2350 ROUTE 63
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:NY
Practice Address - Zip Code:14572-9509
Practice Address - Country:US
Practice Address - Phone:585-728-3541
Practice Address - Fax:585-728-5658
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI01252225100000X
NY031744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
031744OtherNY STATE PT LICENSURE