1578729943 NPI number — MRS. TAMMY A ROCKHILL APN

Table of content: MRS. TAMMY A ROCKHILL APN (NPI 1578729943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578729943 NPI number — MRS. TAMMY A ROCKHILL APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROCKHILL
Provider First Name:
TAMMY
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578729943
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1020 LAUREL OAK RD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
VOORHEES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08043-3518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-782-3300
Provider Business Mailing Address Fax Number:
856-504-8029

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
693 MAIN ST
Provider Second Line Business Practice Location Address:
BOX 367
Provider Business Practice Location Address City Name:
LUMBERTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08048-5043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-261-4058
Provider Business Practice Location Address Fax Number:
609-261-8381
Provider Enumeration Date:
08/05/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  26NJ00165700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 26NJ00165700 . This is a "LICENSE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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