Provider Demographics
NPI:1063481166
Name:RIPPLE, ROCK ELLIOTT (MD)
Entity Type:Individual
Prefix:
First Name:ROCK
Middle Name:ELLIOTT
Last Name:RIPPLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 WASHINGTON ST
Mailing Address - Street 2:SUITE 380
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3441
Mailing Address - Country:US
Mailing Address - Phone:781-769-9045
Mailing Address - Fax:781-769-0420
Practice Address - Street 1:825 WASHINGTON ST
Practice Address - Street 2:SUITE 380
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3441
Practice Address - Country:US
Practice Address - Phone:781-769-9045
Practice Address - Fax:781-769-0420
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA60359207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3062953Medicaid
MA3062953Medicaid
MAE58338Medicare UPIN