Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 003115 | NY |
NPI | 1093951600 |
---|---|
Provider Name | Dr. Jay Harvey Rogove |
First Address | Dix Hills, NY 11746-6439 |
Second Address | Dix Hills, NY 11746-6439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2009 |
Last Update Date | 02/01/2009 |