Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | X002686-1 | NY |
NPI | 1467433367 |
---|---|
Provider Name | Dr. David J. Rogers |
First Address | Huntington Station, NY 11746-4031 |
Second Address | Huntington Station, NY 11746-4031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01743062 | (05) | NY |
T5223 | (02) | NY |