Provider Demographics
NPI:1114110319
Name:ROGOFF, DARA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:
Last Name:ROGOFF
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:DARA
Other - Middle Name:
Other - Last Name:SCHATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:70 E 10TH ST
Mailing Address - Street 2:#7V
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5102
Mailing Address - Country:US
Mailing Address - Phone:646-290-7977
Mailing Address - Fax:
Practice Address - Street 1:28/4 HATZFIRA
Practice Address - Street 2:
Practice Address - City:JERUSALEM
Practice Address - State:ISRAEL
Practice Address - Zip Code:93102
Practice Address - Country:IL
Practice Address - Phone:646-290-7977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016351-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P3722246OtherOXFORD HEALTH