Provider Demographics
NPI:1598700957
Name:DRS. ROGOWSKI & ROGOWSKI PC
Entity Type:Organization
Organization Name:DRS. ROGOWSKI & ROGOWSKI PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROGOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-365-3344
Mailing Address - Street 1:2608 ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19153-1827
Mailing Address - Country:US
Mailing Address - Phone:215-365-3344
Mailing Address - Fax:215-492-0513
Practice Address - Street 1:2608 ISLAND AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19153-1827
Practice Address - Country:US
Practice Address - Phone:215-365-3344
Practice Address - Fax:215-492-0513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001189-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0683580Medicaid
PA18595OtherASH
PA0061070000OtherKEY E.AMERI HEALTH.PER CH
PA0068358001OtherAMERCHOICE
PA4287169OtherAETNA PPO
PA0973431000OtherKEY.EAST.PC & AMERI HEALT
PA113855OtherAETNA HMO
PA48152OtherKEYSTONE MERCY
PA1303354OtherBC BS
PA9339OtherELDER HEALTH
PA48152OtherKEYSTONE MERCY
PA=========OtherCIGNA
PA0068358001OtherAMERCHOICE
PA0683580Medicaid