Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 13436 | RI |
N | 208000000X | Pediatrician | 288135 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | MD13436 | RI |
NPI | 1417123886 |
---|---|
Provider Name | Dr. Tanya Orie Rogo |
First Address | Bronx, NY 10456-3402 |
Second Address | Bronx, NY 10456-3402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2008 |
Last Update Date | 20/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
939025129 | RI MEDICARE GROUP (01) | RI |