MEDICARE: VICTORIA M DELLA ROCCA LDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1104906742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA M DELLA ROCCA LDN

Provider Business Mailing Address
First Line	:	1000 W UPSAL ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-3715
Country	:	US
Telephone Number	:	215-307-5165
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 DELSEA DR
Second Line	:
City	:	WESTVILLE
State	:	NJ
Zip	:	08093-1229
Country	:	US
Telephone Number	:	856-471-2008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/21/2022

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