Provider Demographics
NPI:1770120644
Name:ROCA, JOVELYN CADIZ (PT)
Entity type:Individual
Prefix:
First Name:JOVELYN
Middle Name:CADIZ
Last Name:ROCA
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 1:8158 DONGAN AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3731
Mailing Address - Country:US
Mailing Address - Phone:505-315-0776
Mailing Address - Fax:
Practice Address - Street 1:13618 39TH AVE STE 1004
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5577
Practice Address - Country:US
Practice Address - Phone:718-616-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist