Gregory Rogers, SPEECH AND LANGUAGE
Individual provider Active NPI Speech-Language Pathologist · Port Ewen, NY
NPI 1619190451 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1619190451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 009333-1 (NY)
- Practice address
- 11 Four Sisters LN
Port Ewen, NY 12466-5401 - Phone
- (845) 340-9068
- NPI assigned
- Apr 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009333-1 | NY | MD | Speech-Language Pathologist |
| 009333 | NY | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 009333-1 | NY | Yes |
Addresses
Primary practice location
11 Four Sisters LN
Port Ewen, NY 12466-5401
Mailing address
11 Four Sisters LN
Port Ewen, NY 12466-5401
Phone (845) 340-9068
Other providers in Port Ewen, NY
- Lisa Piccolo
- Port Ewen Pharmacy Inc
- Port Ewen RX Inc
- Racquel Praino
- Barbara Ann Price
- Mary Roosa
- Peter James Rubertone
- Cheyanne Tallas Sandy
- Dana Mary Schechter
- Lori D Schwark
All providers in Port Ewen, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.