Provider Demographics
NPI:1104035666
Name:ROGOWSKI, RAYMOND A (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:A
Last Name:ROGOWSKI
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 1:37 WOODRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:PA
Mailing Address - Zip Code:19373
Mailing Address - Country:US
Mailing Address - Phone:610-459-0673
Mailing Address - Fax:484-574-8052
Practice Address - Street 1:37 WOODRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:PA
Practice Address - Zip Code:19373
Practice Address - Country:US
Practice Address - Phone:610-842-2559
Practice Address - Fax:484-574-8052
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAHD02705L207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology