Individual
DR. JOSE RAMON ROQUE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, BCNS, CNC
Contact information
Practice address
1111 22ND ST, NORTH BERGEN, NJ 07047-2003
(201) 866-8121
(201) 866-8004
Mailing address
1111-22 STREET, NORTH BERGEN, NJ 07047
(201) 866-8121
(201) 866-8004
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
3002
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1045653
NJ HEALTH
NJ
Enumeration date
02/22/2007
Last updated
07/08/2007
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