Provider Demographics
NPI:1497083158
Name:KUPIDLOWSKI-ROGERS, JANICE ANN (RRT,CPFT,AE-C)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:ANN
Last Name:KUPIDLOWSKI-ROGERS
Suffix:
Gender:F
Credentials:RRT,CPFT,AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:321 E ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:HERKIMER
Mailing Address - State:NY
Mailing Address - Zip Code:13350-2016
Mailing Address - Country:US
Mailing Address - Phone:315-867-2885
Mailing Address - Fax:315-867-2756
Practice Address - Street 1:321 E ALBANY ST
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-2016
Practice Address - Country:US
Practice Address - Phone:315-867-2885
Practice Address - Fax:315-867-2756
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004671227900000X, 2279P1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
No2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function Technologist