Provider Demographics
NPI:1144370164
Name:BOCRA, ROBIN J (DPM)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:J
Last Name:BOCRA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 AMWELL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-8212
Mailing Address - Country:US
Mailing Address - Phone:908-359-0137
Mailing Address - Fax:908-359-0297
Practice Address - Street 1:1024 PARK AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3026
Practice Address - Country:US
Practice Address - Phone:908-755-5545
Practice Address - Fax:908-755-6065
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00274700213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJV02854Medicare UPIN
NJ086683Medicare ID - Type UnspecifiedGROUP MEDICARE ID#
NJ086681 TJWMedicare ID - Type UnspecifiedINDIVIDUAL PROVIDER ID#