Provider Demographics
NPI:1447240981
Name:WALENSKY, ROCHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:
Last Name:WALENSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:
Other - Last Name:BERSOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:GRJ 504 MEDICAL WALK IN UNIT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-2707
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156271207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ22201OtherBCBS MA
MA156271OtherTUFTS HEALTH PLAN
MA3206645Medicaid
MA156271OtherTUFTS HEALTH PLAN
MAJ22201OtherBCBS MA