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General NPI Number Information
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NPI Number | 1700331246
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Entity Type | Individual
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Provider Name | PHILIP MANUEL ROJO MSN
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Gender | Male
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Dates
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Enumeration Date | 08/24/2016
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Last Update Date | 08/24/2016
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Provider Practice Location Address
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Address Line | 901 ROUTE 73 N SUITE C
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City | MARLTON
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State | NJ
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Zip | 08053-1226
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Country | US
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Telephone | 856-581-9711
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SPRING ST UNIT 805
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2276
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Country | US
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Telephone | 732-801-0683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00649800
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License Number State | NJ
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