Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 25MB03949500 | NJ |
NPI | 1013104439 |
---|---|
Provider Name | Dr. Gregory Joseph Rokosz |
First Address | Boonton, NJ 07005-9043 |
Second Address | Livingston, NJ 07039-5672 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2007 |
Last Update Date | 30/09/2007 |