Healthcare Provider Details

I. General information

NPI: 1700959897
Provider Name (Legal Business Name): ROCHESTER PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 ROCHESTER HILL RD
ROCHESTER NH
03867-1728
US

IV. Provider business mailing address

163 ROCHESTER HILL RD
ROCHESTER NH
03867-1728
US

V. Phone/Fax

Practice location:
  • Phone: 603-332-0238
  • Fax: 603-332-7098
Mailing address:
  • Phone: 603-332-0238
  • Fax: 603-332-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOYCE A DEJOHN
Title or Position: ASST OFFICE MANAGER
Credential:
Phone: 603-332-0238