Healthcare Provider Details

I. General information

NPI: 1477975720
Provider Name (Legal Business Name): ROCCO FELICE TERRIGNO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2014
Last Update Date: 11/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CENTENNIAL BLVD
VOORHEES NJ
08043-4637
US

IV. Provider business mailing address

1 FEDERAL ST # 100
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 856-325-6789
  • Fax:
Mailing address:
  • Phone: 856-356-4924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25MA09610300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: