Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 0254571 | NY |
Y | 2251G0304X | Physical Therapist - Geriatrics | P10998 | NC |
NPI | 1043251010 |
---|---|
Provider Name | Dr. Stephanie Dagostino Rogers |
First Address | Wilmington, NC 28411-9270 |
Second Address | Wilmington, NC 28411-9270 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 08/01/2021 |