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General NPI Number Information
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NPI Number | 1114183373
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Entity Type | Individual
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Provider Name | DENNIS ROGGEMANN
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Gender | Male
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Dates
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Enumeration Date | 08/06/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 1085 PROSPECT AVE
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092-1508
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Country | US
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Telephone | 973-868-2097
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Fax |
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Provider Business Mailing Address
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Address Line | 1085 PROSPECT AVE
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092-1508
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Country | US
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Telephone |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 131180
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MA37751
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License Number State | NJ
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