Healthcare Provider Details

I. General information

NPI: 1568131415
Provider Name (Legal Business Name): EMMIT J ROJO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 07/30/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

776 NJ-17
PARAMUS NJ
07652
US

IV. Provider business mailing address

102 MADISON AVE FL 8
NEW YORK NY
10016-7584
US

V. Phone/Fax

Practice location:
  • Phone: 201-808-2250
  • Fax: 212-379-2123
Mailing address:
  • Phone: 212-759-2282
  • Fax: 212-379-2123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02044100
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: