Provider Demographics
NPI:1992960991
Name:ALCERA, ROANNA ESPINO (MD)
Entity type:Individual
Prefix:MRS
First Name:ROANNA
Middle Name:ESPINO
Last Name:ALCERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:103 CREEK CROSSING BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036
Mailing Address - Country:US
Mailing Address - Phone:609-491-7021
Mailing Address - Fax:609-784-8300
Practice Address - Street 1:103 CREEK CROSSING BOULEVARD
Practice Address - Street 2:
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036
Practice Address - Country:US
Practice Address - Phone:609-491-7021
Practice Address - Fax:609-784-8300
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-19
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08448900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0174131Medicaid
NJ0174131Medicaid
NJ135152R63Medicare PIN