Healthcare Provider Details

I. General information

NPI: 1023182474
Provider Name (Legal Business Name): ALLAN JOSEPH ROONEY PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 03/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 CENTENNIAL DR
NORTH GRAFTON MA
01536-1860
US

IV. Provider business mailing address

19 DANIELLE DR
GRAFTON MA
01519-1079
US

V. Phone/Fax

Practice location:
  • Phone: 508-839-5500
  • Fax: 508-839-5546
Mailing address:
  • Phone: 508-839-5477
  • Fax: 508-839-5491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6144
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: