Provider Demographics
NPI:1356745855
Name:SEROCK, ROSEMARY (APN-BC)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:
Last Name:SEROCK
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 ARDMORE AVENUE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:08108
Mailing Address - Country:US
Mailing Address - Phone:856-858-2029
Mailing Address - Fax:
Practice Address - Street 1:18 EAST LAUREL ROAD
Practice Address - Street 2:KENNEDY HEALTH SYSTEM (STRATFORD DIVISION)
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084
Practice Address - Country:US
Practice Address - Phone:856-346-6000
Practice Address - Fax:856-346-7681
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00502600363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner