Individual
DR. NICHOLAS ROGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
646 COMMACK RD, R.B.K PEDIATRICS, COMMACK, NY 11725-5404
(631) 499-4114
(631) 499-1468
Mailing address
56 OLD BROOK ROAD, DIX HILLS, NY 11746-6432
(631) 940-2960
(631) 666-1302
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
233227
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00401381
GROUP MA #
NY
05
—
02201256
—
NY
Enumeration date
10/11/2006
Last updated
01/11/2012
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