Healthcare Provider Details

I. General information

NPI: 1609937655
Provider Name (Legal Business Name): ELSIE ROCA-PICCINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WORLDS FAIR DR ROBERT WOOD JOHNSON UNIVERSITY MEDICAL GROUP - SOMERSET
SOMERSET NJ
08873-1344
US

IV. Provider business mailing address

317 GEORGE ST UNIVERSITY MEDICAL GROUP 3RD FLOOR
NEW BRUNSWICK NJ
08901-2008
US

V. Phone/Fax

Practice location:
  • Phone: 732-743-5437
  • Fax:
Mailing address:
  • Phone: 732-235-8282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA68300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA06830000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: