Provider Demographics
NPI:1932461779
Name:ROGERS, SHEILA (MS)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CAT HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11709-3032
Mailing Address - Country:US
Mailing Address - Phone:516-659-1962
Mailing Address - Fax:
Practice Address - Street 1:18 CAT HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11709-3032
Practice Address - Country:US
Practice Address - Phone:516-659-1962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist