Healthcare Provider Details
I. General information
NPI: 1609761865
Provider Name (Legal Business Name): MARY ROCKAS MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
115 MILL ST
BELMONT MA
02478-1064
US
IV. Provider business mailing address
115 MILL STREET MAIL STOP 222
BELMONT MA
02478
US
V. Phone/Fax
- Phone: 781-315-6167
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARY
ROCKAS
Title or Position: MD
Credential: MD
Phone: 781-315-6167