Healthcare Provider Details

I. General information

NPI: 1306291042
Provider Name (Legal Business Name): VICTORIA LEE ROCCIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 CORNWELL DR
BRIDGETON NJ
08302-3602
US

IV. Provider business mailing address

163 BRIDGETON PIKE
MULLICA HILL NJ
08062-2669
US

V. Phone/Fax

Practice location:
  • Phone: 856-455-6770
  • Fax: 856-455-6030
Mailing address:
  • Phone: 856-507-2783
  • Fax: 856-221-4138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number26NJ00631200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00631200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: