Provider Demographics
NPI:1144561721
Name:ROGOWSKI, JERZY MIROSLAW (MD)
Entity Type:Individual
Prefix:DR
First Name:JERZY
Middle Name:MIROSLAW
Last Name:ROGOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2 ELLINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-1102
Mailing Address - Country:US
Mailing Address - Phone:315-507-5081
Mailing Address - Fax:315-738-1663
Practice Address - Street 1:2 ELLINWOOD DR
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1102
Practice Address - Country:US
Practice Address - Phone:315-507-5081
Practice Address - Fax:315-738-1663
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2017-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY212712-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine