Provider Demographics
NPI:1235136011
Name:DMOCHOWSKI, JOHN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:DMOCHOWSKI
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 1:270 TEATICKET HWY
Mailing Address - Street 2:UNIT 1B
Mailing Address - City:TEATICKET
Mailing Address - State:MA
Mailing Address - Zip Code:02536-5671
Mailing Address - Country:US
Mailing Address - Phone:508-548-8626
Mailing Address - Fax:508-548-0260
Practice Address - Street 1:270 TEATICKET HWY
Practice Address - Street 2:UNIT 1B
Practice Address - City:TEATICKET
Practice Address - State:MA
Practice Address - Zip Code:02536-5671
Practice Address - Country:US
Practice Address - Phone:508-548-8626
Practice Address - Fax:508-548-0260
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA39343174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAL02012OtherBLUE CROSS BLUE SHEILD
MA713643OtherTUFTS
MA149115000OtherMAGELLAN
MA149115000OtherMAGELLAN
MA2058006Medicare ID - Type Unspecified
MA713643OtherTUFTS