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NPI Code Detail

MEDICARE: MARK ROGOMENTICH

MEDICARE: MARK ROGOMENTICH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPTL89258MA

General Provider Information

NPI Number : 1033061650
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK ROGOMENTICH
Provider Business Mailing Address
First Line : 12 FIORENZA DR
Second Line :
City : WILMINGTON
State : MA
Zip : 01887-4427
Country : US
Telephone Number : 978-604-4318
Fax Number :
Provider Business Practice Location Address
First Line : 1493 CAMBRIDGE ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02139-1099
Country : US
Telephone Number : 617-665-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2026
Last Update Date : 02/14/2026

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Directions to “ MARK ROGOMENTICH ” Practice Location

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