1326290743 NPI number — THE ROGOSIN INSTITUTE, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326290743 NPI number — THE ROGOSIN INSTITUTE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE ROGOSIN INSTITUTE, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CLINICAL LABORATORY
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326290743
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
504-506 EAST 74TH STREET
Provider Second Line Business Mailing Address:
5TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10021-3486
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-317-0684
Provider Business Mailing Address Fax Number:
212-249-4659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 EAST 67TH STREET
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10065-6275
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-570-3220
Provider Business Practice Location Address Fax Number:
212-570-3083
Provider Enumeration Date:
10/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GORDON
Authorized Official First Name:
BRUCE
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CHEIF OPERATING OFFICER
Authorized Official Telephone Number:
212-746-1554

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  33D0653383 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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