Individual
MR. EDWIN ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
65 W JIMMIE LEEDS RD, POMONA, NJ 08240-9102
(609) 652-1000
Mailing address
27 ABINGTON CT, MAYS LANDING, NJ 08330-1939
(609) 553-6692
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ01169900
NJ
Other
Enumeration date
12/02/2021
Last updated
12/02/2021
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