MEDICARE: BRADLEY ROCKOFF M.D.

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	207P00000X	Emergency Medicine Physician	277682	NY

General Provider Information

NPI Number	:	1568752772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY ROCKOFF M.D.

Provider Business Mailing Address
First Line	:	4535 DRESSLER RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2545
Country	:	US
Telephone Number	:	855-687-0618
Fax Number	:

Provider Business Practice Location Address
First Line	:	7930 FLOYD CURL DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3925
Country	:	US
Telephone Number	:	210-297-5000
Fax Number	:

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

Provider Enumeration Date	:	04/10/2011
Last Update Date	:	09/18/2024

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