Provider Demographics
NPI:1578758124
Name:ROCKACY, MATTHEW J (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:ROCKACY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:590 COURT ST
Mailing Address - Street 2:DEPARTMENT OF GASTROENTEROLOGY
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-1719
Mailing Address - Country:US
Mailing Address - Phone:603-354-6515
Mailing Address - Fax:603-354-5429
Practice Address - Street 1:590 COURT ST
Practice Address - Street 2:DEPARTMENT OF GASTROENTEROLOGY
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1719
Practice Address - Country:US
Practice Address - Phone:603-354-6515
Practice Address - Fax:603-354-5429
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT189084390200000X
NH15674207RG0100X
PAMD445519207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program