Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 25MD00274700 | NJ |
NPI | 1144370164 |
---|---|
Provider Name | Robin J Bocra |
First Address | Hillsborough, NJ 08844-8212 |
Second Address | Plainfield, NJ 07060-3026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 21/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V02854 | (02) | NJ |