Provider Demographics
NPI:1366674145
Name:MARROCCO, MONICA (LAC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MARROCCO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:NY
Mailing Address - Zip Code:14464-9524
Mailing Address - Country:US
Mailing Address - Phone:585-303-2015
Mailing Address - Fax:
Practice Address - Street 1:1687 ENGLISH RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-1692
Practice Address - Country:US
Practice Address - Phone:585-303-2015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003881-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist