Provider Demographics
NPI:1801097647
Name:JOSEPH P LAROCHELLE
Entity type:Organization
Organization Name:JOSEPH P LAROCHELLE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:O.D./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:LAROCHELLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-225-2512
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03216-0032
Mailing Address - Country:US
Mailing Address - Phone:603-735-6060
Mailing Address - Fax:603-735-6070
Practice Address - Street 1:8 N STATE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4038
Practice Address - Country:US
Practice Address - Phone:603-225-2512
Practice Address - Fax:603-225-3249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0362152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30008880Medicaid
NH30353247Medicaid
NH30353247Medicaid
NHNH7879Medicare PIN