Individual
PHILIP GERARD RODGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
16 GARY ST, PORT JEFFERSON STATION, NY 11776-2870
(631) 828-2792
Mailing address
16 GARY ST, PORT JEFFERSON STATION, NY 11776-2870
(631) 828-2792
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
446862
NY
Other
Enumeration date
10/07/2009
Last updated
10/07/2009
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