Provider Demographics
NPI:1841274800
Name:ROGERS, JOSEPH K (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:K
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 ALBION OVAL
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-3600
Mailing Address - Country:US
Mailing Address - Phone:914-964-4322
Mailing Address - Fax:914-964-4767
Practice Address - Street 1:967 N BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1301
Practice Address - Country:US
Practice Address - Phone:914-964-4330
Practice Address - Fax:914-964-4767
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1617362085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00889327Medicaid
NY00889327Medicaid
NYA62676Medicare UPIN