Healthcare Provider Details

I. General information

NPI: 1295998078
Provider Name (Legal Business Name): MATTHEW J ROGALSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 DIAMOND HILL RD
WOONSOCKET RI
02895-1771
US

IV. Provider business mailing address

26 JASONS GRANT DR
CUMBERLAND RI
02864-1649
US

V. Phone/Fax

Practice location:
  • Phone: 401-762-1511
  • Fax: 401-762-1609
Mailing address:
  • Phone: 401-441-9920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number251925
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD13007
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number251925
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberMD13007
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: