Provider Demographics
NPI:1770080509
Name:ROCCATO, MARY KATHRYN (MD)
Entity type:Individual
Prefix:
First Name:MARY KATHRYN
Middle Name:
Last Name:ROCCATO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY KATE
Other - Middle Name:
Other - Last Name:ROCCATO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-206-4786
Mailing Address - Fax:856-206-4789
Practice Address - Street 1:401 YOUNG AVE STE 275A
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3130
Practice Address - Country:US
Practice Address - Phone:856-206-4786
Practice Address - Fax:856-206-4789
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11188400207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology