Individual
KSENIA MARY ROGALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
53 FRONTAGE RD OFC 114, HAMPTON, NJ 08827-4031
(833) 351-8255
Mailing address
109 W 27TH ST RM 5S, NEW YORK, NY 10001-6208
(833) 351-8255
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
02009271A
IN
2084P0800X
Psychiatry Physician
20A25622
CA
2084P0800X
Psychiatry Physician
Primary
25MB13051300
NJ
2084P0800X
Psychiatry Physician
345676
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2017
Last updated
07/24/2026
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