Healthcare Provider Details

I. General information

NPI: 1851323927
Provider Name (Legal Business Name): WILLIAM H RODGERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56-45 MAIN ST NYHQ-PATHOLOGY
FLUSHING NY
11355-4592
US

IV. Provider business mailing address

56-45 MAIN ST NYHQ-PATHOLOGY
FLUSHING NY
11355-4592
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-1141
  • Fax: 718-661-7745
Mailing address:
  • Phone: 718-670-1141
  • Fax: 718-661-7745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberD0063547
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: