Provider Demographics
NPI:1356313944
Name:ROCKOFF, THOMAS A (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:ROCKOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1312 WEST MAIN STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-756-6722
Mailing Address - Fax:203-756-2448
Practice Address - Street 1:166 WATERBURY RD STE 104
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1246
Practice Address - Country:US
Practice Address - Phone:203-756-6722
Practice Address - Fax:203-756-2448
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT039233207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001392331Medicaid
CT001392331Medicaid
CT11008226Medicare ID - Type Unspecified