Provider Demographics
NPI:1003959917
Name:ALAN ROCKOFF, M.D, LLC
Entity Type:Organization
Organization Name:ALAN ROCKOFF, M.D, LLC
Other - Org Name:ROCKOFF DERMATOLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:SIDNEY
Authorized Official - Last Name:ROCKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-731-2390
Mailing Address - Street 1:1101 BEACON ST
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5587
Mailing Address - Country:US
Mailing Address - Phone:617-731-2390
Mailing Address - Fax:617-731-1283
Practice Address - Street 1:1101 BEACON ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5587
Practice Address - Country:US
Practice Address - Phone:617-731-2390
Practice Address - Fax:617-731-1283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA041315174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty