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General NPI Number Information
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NPI Number | 1558688820
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Entity Type | Individual
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Provider Name | CECILIA ALEJANDRA LAROCCA
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Gender | Female
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 03/27/2018
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Provider Practice Location Address
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Address Line | 218 N CHARLES ST APT. 1511
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City | BALTIMORE
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State | MD
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Zip | 21201-4021
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Country | US
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Telephone | 646-483-8936
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Fax |
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Provider Business Mailing Address
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Address Line | 218 N CHARLES ST APT. 1511
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City | BALTIMORE
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State | MD
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Zip | 21201-4021
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Country | US
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Telephone | 646-483-8936
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 265984
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License Number State | MA
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