MEDICARE: MRS. SARAH CATHERINE LAROCQUE R.D.

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
1	133V00000X	Registered Dietitian	2929	MA

General Provider Information

NPI Number	:	1326394289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH CATHERINE LAROCQUE R.D.

Provider Business Mailing Address
First Line	:	355 WAVERLEY OAKS RD
Second Line	:	SUITE 100
City	:	WALTHAM
State	:	MA
Zip	:	02452-8474
Country	:	US
Telephone Number	:	781-314-7600
Fax Number	:	781-314-7666

Provider Business Practice Location Address
First Line	:	355 WAVERLEY OAKS RD
Second Line	:	SUITE 100
City	:	WALTHAM
State	:	MA
Zip	:	02452-8474
Country	:	US
Telephone Number	:	781-314-7600
Fax Number	:	781-314-7666

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2012
Last Update Date	:	12/03/2012

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