Provider Demographics
NPI:1235496720
Name:ROGERS, MARGARET (CSB)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:CSB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SUMMIT AVE
Mailing Address - Street 2:UNIT C
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2305
Mailing Address - Country:US
Mailing Address - Phone:617-312-8871
Mailing Address - Fax:617-264-0976
Practice Address - Street 1:101 SUMMIT AVE
Practice Address - Street 2:UNIT C
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-2305
Practice Address - Country:US
Practice Address - Phone:617-312-8871
Practice Address - Fax:617-264-0976
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner