Provider Demographics
NPI:1790058170
Name:SHARI A. ROGUSKI DC, LLC
Entity Type:Organization
Organization Name:SHARI A. ROGUSKI DC, LLC
Other - Org Name:SHARI A. ROGUSKI DC, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROGUSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-245-8855
Mailing Address - Street 1:PO BOX 373
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-0373
Mailing Address - Country:US
Mailing Address - Phone:203-245-8000
Mailing Address - Fax:203-245-8855
Practice Address - Street 1:145 DURHAM RD
Practice Address - Street 2:SUITE 6
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443
Practice Address - Country:US
Practice Address - Phone:203-245-8000
Practice Address - Fax:203-245-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty