Individual
EILEEN LEARY ROGGEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 SCOUTING BLVD, MEDFORD, NY 11763-2220
(631) 297-3202
Mailing address
1 SCOUTING BLVD, MEDFORD, NY 11763-2220
(631) 297-3202
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
202986
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202986
SPECIAL EDUCATION PERMANENT
NY
Enumeration date
04/16/2018
Last updated
04/16/2018
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