Basic Information
| Provider Information | |||||||||
| NPI: | 1609937655 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ROCA-PICCINI | ||||||||
| FirstName: | ELSIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 317 GEORGE ST | ||||||||
| Address2: | UNIVERSITY MEDICAL GROUP 3RD FLOOR | ||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089012008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322358282 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 WORLDS FAIR DR | ||||||||
| Address2: | ROBERT WOOD JOHNSON UNIVERSITY MEDICAL GROUP - SOMERSET | ||||||||
| City: | SOMERSET | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088731344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327435437 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 07/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MA68300 | NJ | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 25MA06830000 | NJ | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 8238804 | 05 | NJ | MEDICAID |