MEDICARE: EMILY ROCHA

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	152W00000X	Optometrist	5503	MA

General Provider Information

NPI Number	:	1407429343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ROCHA

Provider Business Mailing Address
First Line	:	50 HAMILTON ST
Second Line	:
City	:	EVERETT
State	:	MA
Zip	:	02149-5325
Country	:	US
Telephone Number	:	857-615-9071
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 LINCOLN ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02461-1526
Country	:	US
Telephone Number	:	857-615-9071
Fax Number	:

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

Provider Enumeration Date	:	07/19/2021
Last Update Date	:	11/22/2021

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Directions to “ EMILY ROCHA ” Practice Location

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