Healthcare Provider Details

I. General information

NPI: 1386967735
Provider Name (Legal Business Name): SCOTT J ROCCHIO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 ROOSEVELT DR
DERBY CT
06418-1627
US

IV. Provider business mailing address

412 ROOSEVELT DR
DERBY CT
06418-1627
US

V. Phone/Fax

Practice location:
  • Phone: 203-736-1762
  • Fax: 203-736-3450
Mailing address:
  • Phone: 203-736-1762
  • Fax: 203-736-3452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number001792
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: