Individual
GARY I ROGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19 BRADHURST AVE, SUITE 3090N, HAWTHORNE, NY 10532-2140
(914) 592-2400
(914) 592-2424
Mailing address
19 BRADHURST AVE, SUITE 3090N, HAWTHORNE, NY 10532-2140
(914) 592-2400
(914) 592-2424
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
179583
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01629074
—
NY
01
—
0272083
CIGNA
—
01
—
264709927
AFFINITY
NY
01
—
264709927
HUDSON HEALTH
—
01
—
3023285
MVP
—
01
—
666M81
EMPIRE BCBS
NY
01
—
981414
WELLCARE
—
Enumeration date
10/27/2006
Last updated
02/18/2015
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