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NPI Code Detail

MEDICARE: ANALIA LARROQUETTE RD

MEDICARE: ANALIA LARROQUETTE RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian86299069MA

General Provider Information

NPI Number : 1083566210
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANALIA LARROQUETTE RD
Provider Business Mailing Address
First Line : 103 HAWTHORNE WAY APT 224
Second Line :
City : LAWRENCE
State : MA
Zip : 01843-3866
Country : US
Telephone Number : 248-931-9115
Fax Number :
Provider Business Practice Location Address
First Line : 85 HERRICK ST
Second Line :
City : BEVERLY
State : MA
Zip : 01915-1790
Country : US
Telephone Number : 978-922-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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Directions to “ ANALIA LARROQUETTE RD” Practice Location

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