Physician Compare National (NPI:1558809640)

HEALTHCARE PROVIDER: MARY ALYCE ROGERS LCSW-R

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1558809640
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224306667
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170608000184
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ROGERS
	Individual professional last name
Provider First Name	MARY ALYCE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	64 OLD RIVERHEAD RD
	Group Practice or individual's line 1 address
City	WESTHAMPTON BEACH
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	119781451
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y