Provider Demographics
NPI:1164503231
Name:KAPLAN, ROGER (DC)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:
Last Name:KAPLAN
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:PO BOX 466
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778
Mailing Address - Country:US
Mailing Address - Phone:631-744-4688
Mailing Address - Fax:631-744-3220
Practice Address - Street 1:799 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778
Practice Address - Country:US
Practice Address - Phone:631-744-4688
Practice Address - Fax:631-744-3220
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC01917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X11671Medicare ID - Type Unspecified
T51924Medicare UPIN