Healthcare Provider Details

I. General information

NPI: 1568752772
Provider Name (Legal Business Name): BRADLEY ROCKOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2011
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7930 FLOYD CURL DR
SAN ANTONIO TX
78229-3925
US

IV. Provider business mailing address

4535 DRESSLER RD NW
CANTON OH
44718-2545
US

V. Phone/Fax

Practice location:
  • Phone: 210-297-5000
  • Fax:
Mailing address:
  • Phone: 855-687-0618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number277682
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: