Provider Demographics
NPI:1972831691
Name:ROCHFORD, PETER JOHN
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:JOHN
Last Name:ROCHFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-1085
Mailing Address - Country:US
Mailing Address - Phone:413-547-8000
Mailing Address - Fax:
Practice Address - Street 1:627 RANDALL RD
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-1085
Practice Address - Country:US
Practice Address - Phone:413-547-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA202069363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner