Healthcare Provider Details

I. General information

NPI: 1114110319
Provider Name (Legal Business Name): DARA ROGOFF MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DARA SCHATT MS, CCC-SLP

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28/4 HATZFIRA
JERUSALEM ISRAEL
93102
IL

IV. Provider business mailing address

70 E 10TH ST #7V
NEW YORK NY
10003-5102
US

V. Phone/Fax

Practice location:
  • Phone: 646-290-7977
  • Fax:
Mailing address:
  • Phone: 646-290-7977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number016351-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: