Provider Demographics
NPI:1932215290
Name:ROGALSKI, MONICA M (DO)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:M
Last Name:ROGALSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:399 COUNTY ROUTE 22
Mailing Address - Street 2:RENASCENT HEALTH CENTER
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-3266
Mailing Address - Country:US
Mailing Address - Phone:518-828-5656
Mailing Address - Fax:518-822-9288
Practice Address - Street 1:399 CRT 22
Practice Address - Street 2:RENASCENT HEALTH CENTER
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534
Practice Address - Country:US
Practice Address - Phone:518-828-5656
Practice Address - Fax:518-822-9288
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2010-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY203485-1204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2034858OtherWCB
G37672Medicare UPIN
NY2034858OtherWCB