Provider Demographics
NPI:1417965773
Name:RUOCCO, MARY-PATRICE (MS,RD,LDN)
Entity Type:Individual
Prefix:
First Name:MARY-PATRICE
Middle Name:
Last Name:RUOCCO
Suffix:
Gender:F
Credentials:MS,RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02770-2227
Mailing Address - Country:US
Mailing Address - Phone:508-295-4134
Mailing Address - Fax:508-295-4134
Practice Address - Street 1:387 HIGH ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02770-2227
Practice Address - Country:US
Practice Address - Phone:508-295-4134
Practice Address - Fax:508-295-4134
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA145492133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered