Basic Information
| Provider Information | |||||||||
| NPI: | 1003959917 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALAN ROCKOFF, M.D, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ROCKOFF DERMATOLOGY GROUP | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 BEACON ST | ||||||||
| Address2: | SUITE 1E | ||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024465587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177312390 | ||||||||
| FaxNumber: | 6177311283 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 BEACON ST | ||||||||
| Address2: | SUITE 1E | ||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024465587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177312390 | ||||||||
| FaxNumber: | 6177311283 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 10/15/2007 | ||||||||
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| AuthorizedOfficialLastName: | ROCKOFF | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
| AuthorizedOfficialMiddleName: | SIDNEY | ||||||||
| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 6177312390 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 041315 | MA | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.