Individual
ROBERT JOHN ROUGHLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2290
(631) 261-4400
Mailing address
166 AVE C, HOLBROOK, NY 11741-1417
(631) 467-4388
Taxonomy
Speciality
Code
Description
License number
State
2471R0002X
Radiation Therapy Radiologic Technologist
Primary
731459
NY
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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