Provider Demographics
NPI:1689847782
Name:ROGERS, ROBERT R (AUDIOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:R
Last Name:ROGERS
Suffix:
Gender:M
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5334
Mailing Address - Country:US
Mailing Address - Phone:401-728-0140
Mailing Address - Fax:
Practice Address - Street 1:333 SCHOOL ST
Practice Address - Street 2:302
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5334
Practice Address - Country:US
Practice Address - Phone:401-728-0140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI0035231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist