Provider Demographics
NPI:1053157982
Name:ROCCA, NICOLE IRENE
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:IRENE
Last Name:ROCCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:IRENE
Other - Last Name:AMDERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1055 ESPLANADE AVE APT 6I
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1282
Mailing Address - Country:US
Mailing Address - Phone:347-720-3337
Mailing Address - Fax:
Practice Address - Street 1:1419 SHAKESPEARE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-1851
Practice Address - Country:US
Practice Address - Phone:718-732-7080
Practice Address - Fax:718-243-1814
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical