Provider Demographics
NPI:1043394430
Name:MOGIELNICKI, ROBERT PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PETER
Last Name:MOGIELNICKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BLACK HILL RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03781-5131
Mailing Address - Country:US
Mailing Address - Phone:603-298-5874
Mailing Address - Fax:
Practice Address - Street 1:VETERANS HOSPITAL
Practice Address - Street 2:215 NORTH MAIN STREET
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05009-0001
Practice Address - Country:US
Practice Address - Phone:802-295-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30198207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine