Provider Demographics
NPI:1578520060
Name:ROCCO, PASQUALE M (MD)
Entity Type:Individual
Prefix:DR
First Name:PASQUALE
Middle Name:M
Last Name:ROCCO
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 1:262 NEW LUDLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4324
Mailing Address - Country:US
Mailing Address - Phone:413-586-0829
Mailing Address - Fax:
Practice Address - Street 1:11 HOSPITAL DR FL 3
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6601
Practice Address - Country:US
Practice Address - Phone:413-540-5048
Practice Address - Fax:413-540-5049
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031093208600000X
MA281901208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001310937Medicaid
F71561Medicare UPIN
CT001310937Medicaid