Provider Demographics
NPI:1982904728
Name:ROCCO A GILIBERTI DO LLC
Entity Type:Organization
Organization Name:ROCCO A GILIBERTI DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:JAWIDZIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-296-2267
Mailing Address - Street 1:2911 ROUTE 88
Mailing Address - Street 2:SUITE B3
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2871
Mailing Address - Country:US
Mailing Address - Phone:732-892-9920
Mailing Address - Fax:
Practice Address - Street 1:2911 ROUTE 88
Practice Address - Street 2:SUITE B3
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-2871
Practice Address - Country:US
Practice Address - Phone:732-892-9920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MBO44947207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
457645Medicare PIN