Provider Demographics
NPI:1528238813
Name:VALERIE ROCKENBERGER D O INC
Entity type:Organization
Organization Name:VALERIE ROCKENBERGER D O INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ROCKENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-426-2900
Mailing Address - Street 1:1517 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:EAST PALESTINE
Mailing Address - State:OH
Mailing Address - Zip Code:44413-1153
Mailing Address - Country:US
Mailing Address - Phone:330-426-2900
Mailing Address - Fax:888-525-7701
Practice Address - Street 1:1517 N MARKET ST
Practice Address - Street 2:
Practice Address - City:EAST PALESTINE
Practice Address - State:OH
Practice Address - Zip Code:44413-1153
Practice Address - Country:US
Practice Address - Phone:330-426-2900
Practice Address - Fax:888-525-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007008207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2078086Medicaid
OH2078086Medicaid
OH4036121Medicare PIN