Individual
JOHN PETER ROGOWSKI JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2819 MAIN ST, BRIDGEPORT, CT 06606-4202
(203) 367-5589
(203) 330-0838
Mailing address
2819 MAIN ST, BRIDGEPORT, CT 06606-4202
(203) 367-5589
(203) 330-0838
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001793
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001107167
MHN
CT
01
—
060001793CT02
ANTHEM, BCBS,
CT
01
—
338435
VALUEOPTIONS
CT
01
—
P00039160
RAILROAD MEDICARE
CT
Enumeration date
01/04/2007
Last updated
07/09/2007
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