Provider Demographics
NPI:1669453361
Name:ROCHMAN, GUY M (MD)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:M
Last Name:ROCHMAN
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 1:100 HIGHLAND ST
Mailing Address - Street 2:SUITE 226
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3881
Mailing Address - Country:US
Mailing Address - Phone:617-876-1600
Mailing Address - Fax:617-696-0766
Practice Address - Street 1:100 HIGHLAND STREET
Practice Address - Street 2:SUITE 226
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3881
Practice Address - Country:US
Practice Address - Phone:617-876-1600
Practice Address - Fax:617-696-0766
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA45844174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA045844OtherTUFTS
MA5743108OtherCIGNA
MA240000731OtherRAILROAD MEDICARE
MAJ02940OtherBCBS
MA042840603OtherTRICARE
MA042840603OtherAETNA
MA21031OtherHARVARD PILGRIM
MA6177611Medicaid
MA240000731OtherRAILROAD MEDICARE
MAA56870Medicare UPIN