Provider Demographics
NPI:1518961143
Name:COVEN, ROGER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:
Last Name:COVEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 N FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1139
Mailing Address - Country:US
Mailing Address - Phone:201-236-2100
Mailing Address - Fax:201-236-5269
Practice Address - Street 1:581 N FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1139
Practice Address - Country:US
Practice Address - Phone:201-236-2100
Practice Address - Fax:201-236-5269
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04007000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP383592OtherOXFORD ID #
NJ160045031OtherRAILROAD MDCR #
NJ872591OtherAETNA HMO ID #
NJ56F273OtherEMPIRE BC/BS (RAMSEY)
NJ56F272OtherEMPIRE BC/BS (MIDLAND PK)
NJ4129937OtherAETNA PPO ID #
NJ872591OtherAETNA HMO ID #
NJ56F273OtherEMPIRE BC/BS (RAMSEY)