Healthcare Provider Details

I. General information

NPI: 1326518911
Provider Name (Legal Business Name): JENNA MARIE ROGOFF OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2018
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 S MAIN STREET SUITE 400
NEW CITY NY
10956
US

IV. Provider business mailing address

13 ROSEMONT DRIVE
NEW CITY NY
10956
US

V. Phone/Fax

Practice location:
  • Phone: 845-638-1592
  • Fax: 845-638-1830
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number027400
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code224ZE0001X
TaxonomyEnvironmental Modification Occupational Therapy Assistant
License Number409521
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: