Healthcare Provider Details

I. General information

NPI: 1285651034
Provider Name (Legal Business Name): RT BOCK MD CONSULTANCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 UNION VALLEY RD
NEWFOUNDLAND NJ
07435-1603
US

IV. Provider business mailing address

91 UNION VALLEY RD
NEWFOUNDLAND NJ
07435-1603
US

V. Phone/Fax

Practice location:
  • Phone: 201-492-4987
  • Fax: 201-326-5121
Mailing address:
  • Phone: 201-492-4987
  • Fax: 201-326-5121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMA65099
License Number StateNJ

VIII. Authorized Official

Name: DR. ROBERT TAMAS BOCK JR.
Title or Position: DOCTOR
Credential: M.D.
Phone: 201-492-4987