Provider Demographics
NPI:1205987310
Name:ROGGE, SCOTT DEBOW (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:DEBOW
Last Name:ROGGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 MIKE RD
Mailing Address - Street 2:PO BOX 1505
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-2212
Mailing Address - Country:US
Mailing Address - Phone:860-567-5033
Mailing Address - Fax:
Practice Address - Street 1:3424 KOSSUTH AVE
Practice Address - Street 2:SUITE 11A-20
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2410
Practice Address - Country:US
Practice Address - Phone:718-519-3990
Practice Address - Fax:718-519-3442
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1673902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry