Provider Demographics
NPI:1114140316
Name:ROHER, HAROLD (DC)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:
Last Name:ROHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 JERICHO TPKE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3009
Mailing Address - Country:US
Mailing Address - Phone:631-664-6492
Mailing Address - Fax:
Practice Address - Street 1:30 JERICHO TPKE
Practice Address - Street 2:SUITE 150
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3009
Practice Address - Country:US
Practice Address - Phone:631-664-6492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005709111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX40321Medicare ID - Type Unspecified