Provider Demographics
NPI:1780603381
Name:CAVENG, ROCCO F JR (DO)
Entity type:Individual
Prefix:DR
First Name:ROCCO
Middle Name:F
Last Name:CAVENG
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:218C SUNSET RD
Practice Address - Street 2:SUITE C
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1104
Practice Address - Country:US
Practice Address - Phone:609-877-0400
Practice Address - Fax:609-877-1682
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB08088200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0112151Medicaid
DE020815C29Medicare PIN
NJ107653ASDMedicare PIN
NJI69016Medicare UPIN