Provider Demographics
NPI:1891347753
Name:ROOKEY, KRISTOPHER J (HIS)
Entity Type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:J
Last Name:ROOKEY
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2430
Mailing Address - Country:US
Mailing Address - Phone:315-532-3477
Mailing Address - Fax:
Practice Address - Street 1:45 1/2 W BRIDGE ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2024
Practice Address - Country:US
Practice Address - Phone:315-532-3477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1400045262237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist