Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 37LC00011000 | NJ |
N | 101YM0800X | Mental Health Counselor | 37PC00011700 | NJ |
NPI | 1003026386 |
---|---|
Provider Name | Mr. Rocco Briscese |
First Address | East Brunswick, NJ 08816-3938 |
Second Address | Elizabeth, NJ 07206-1261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |