Roger Lee Gully, CERTIFIED REHAB THER

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

26BT00004800 Issued in NJ

Practice address

62 Fairmount Ave
Clifton, NJ 07011-3007

Phone

(973) 340-0890

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174539944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 FAIRMOUNT AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070113007",
            "telephone_number": "973-340-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 FAIRMOUNT AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070113007",
            "telephone_number": "973-340-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLY",
        "first_name": "ROGER",
        "middle_name": "LEE",
        "credential": "CERTIFIED REHAB THER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NJ",
            "license": "26BT00004800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadiya Grubyak, APN
• Ariolis Carmelina Grullon Okumus, M.D.
• Alana Naomi Grundel, DPT
• Yesenia Elizabeth Guardado
• Guardian Living Care, Inc.
• Michael Guma, D.O.
• Angela Lijoi Gunn, MD
• Ajay Gupta, M.D.
• Ashok Gupta
• Somi Gupta, MA-CCC-A

• Rehabilitation Practitioner in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Rehabilitation Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.