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NPI Code Detail

MEDICARE: MARILYN ROCA ENRIQUEZ BCBA

MEDICARE: MARILYN ROCA ENRIQUEZ BCBA
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
1103K00000XBehavior Analyst1-18-33281NJ

General Provider Information

NPI Number : 1245896927
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN ROCA ENRIQUEZ BCBA
Provider Business Mailing Address
First Line : 12 CELIA TER
Second Line :
City : BELLEVILLE
State : NJ
Zip : 07109-1466
Country : US
Telephone Number : 786-260-1490
Fax Number :
Provider Business Practice Location Address
First Line : 158 NEWARK AVE
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07302-2812
Country : US
Telephone Number : 201-324-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2019
Last Update Date : 05/17/2019

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Directions to “ MARILYN ROCA ENRIQUEZ BCBA” Practice Location

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