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General NPI Number Information
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NPI Number | 1093055469
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Entity Type | Individual
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Provider Name | DAVID ROGOT OPHTHALMIC DISPENSE
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Gender | Male
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Dates
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Enumeration Date | 02/22/2013
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 125 MONTAUK HWY
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City | WESTHAMPTON
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State | NY
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Zip | 11977-1409
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Country | US
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Telephone | 917-538-7209
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Fax |
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Provider Business Mailing Address
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Address Line | 125 MONTAUK HWY
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City | WESTHAMPTON
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State | NY
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Zip | 11977-1409
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Country | US
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Telephone | 917-538-7209
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 004134
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License Number State | NY
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