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General NPI Number Information
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NPI Number | 1134532591
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Entity Type | Organization
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Legal Business Name | ROGER S MADRIS, M.D., P.C.
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 10 RYE RIDGE PLZ SUITE 105
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City | RYE BROOK
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State | NY
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Zip | 10573-2828
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Country | US
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Telephone | 914-253-6504
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Fax | 914-253-6507
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Provider Business Mailing Address
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Address Line | 10 RYE RIDGE PLZ SUITE 105
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City | RYE BROOK
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State | NY
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Zip | 10573-2828
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Country | US
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Telephone | 914-253-6504
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Fax | 914-253-6507
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROGER SCOTT MADRIS
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Credential | M.D.
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Telephone | 914-253-6504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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