Individual
DR. REGINA CELESTE LAROCQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD MPH
Contact information
Practice address
55 FRUIT STREET GRJ 504, INFECTIOUS DISEASE ASSOCIATES, BOSTON, MA 02114-2696
(617) 724-7511
(617) 726-7416
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 643-5557
(617) 726-7416
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
208572
MA
207RI0200X
Infectious Disease Physician
Primary
208572
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0143910
—
MA
01
—
456933
TUFTS HEALTH PLAN
MA
01
—
J23541
BCBS MA
MA
Enumeration date
12/05/2005
Last updated
11/29/2012
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