Provider Demographics
NPI:1659437598
Name:ROGAN, DONNA M (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:ROGAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3444 KOSSUTH AVE
Mailing Address - Street 2:2ND FL.
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2410
Mailing Address - Country:US
Mailing Address - Phone:718-920-5871
Mailing Address - Fax:718-652-5707
Practice Address - Street 1:3444 KOSSUTH AVE
Practice Address - Street 2:2ND FL.
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2410
Practice Address - Country:US
Practice Address - Phone:718-920-5871
Practice Address - Fax:718-652-5707
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2011-10-13
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Provider Licenses
StateLicense IDTaxonomies
NY157446208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01726681Medicaid
NY01726681Medicaid