Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | F306250-1 | NY |
Y | 363LA2200X | Nurse Practitioner - Adult Health | SP012477 | PA |
NPI | 1023353596 |
---|---|
Provider Name | Jonathan Rockfeld |
First Address | East Stroudsburg, PA 18301-3006 |
Second Address | New York, NY 10019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2012 |
Last Update Date | 18/03/2021 |