Active NPI
Jennifer Rogan, OTR/L
- Occupational Therapist
- Manorville, NY
National Provider Identifier
1871963694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 019428-1
- Practice address
- 5 Tee View CT
Manorville, NY 11949-2939 - Phone
- (631) 909-4678
- Fax
- (631) 874-4105
- NPI assigned
- Oct 6, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 019428-1 | NY | Primary |
Addresses
Primary practice location
5 Tee View CT
Manorville, NY 11949-2939
Mailing address
74 Greenlawn Boulevard
Valley Stream, NY 11580
Phone (516) 596-7550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019428 | NY | MD | Clinical Psychologist |
| 019428-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444089600000",
"number": "1871963694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 GREENLAWN BOULEVARD",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "11580",
"telephone_number": "516-596-7550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 TEE VIEW CT",
"city": "MANORVILLE",
"state": "NY",
"postal_code": "119492939",
"telephone_number": "631-909-4678",
"fax_number": "631-874-4105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGAN",
"first_name": "JENNIFER",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-06",
"last_updated": "2015-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "019428-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manorville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.