Healthcare Provider Details

I. General information

NPI: 1679654008
Provider Name (Legal Business Name): THOMAS F. ROCERETO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CENTENNIAL BLVD
VOORHEES NJ
08043-4689
US

IV. Provider business mailing address

3 COOPER PLZ SUITE 502
CAMDEN NJ
08103-1438
US

V. Phone/Fax

Practice location:
  • Phone: 856-325-6644
  • Fax:
Mailing address:
  • Phone: 856-963-6888
  • Fax: 856-968-8499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberMA23746
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: