Healthcare Provider Details

I. General information

NPI: 1205761715
Provider Name (Legal Business Name): ASHLEY ROGERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 EASTCHESTER RD
BRONX NY
10461-2320
US

IV. Provider business mailing address

1816 RADCLIFF AVE APT 2A
BRONX NY
10462-3734
US

V. Phone/Fax

Practice location:
  • Phone: 718-904-2871
  • Fax:
Mailing address:
  • Phone: 917-717-4047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF408263
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: