Healthcare Provider Details

I. General information

NPI: 1831270453
Provider Name (Legal Business Name): ADRIENNE R ROGERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 WESTCHESTER AVE
PURCHASE NY
10577-2574
US

IV. Provider business mailing address

800 WESTCHESTER AVE STE N715
RYE BROOK NY
10573-1369
US

V. Phone/Fax

Practice location:
  • Phone: 914-607-6260
  • Fax: 914-607-6261
Mailing address:
  • Phone: 914-607-5730
  • Fax: 914-457-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number178796
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: