Provider Demographics
NPI:1023294246
Name:ROGALSKI, SAMANTHA R (RPA-C)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:R
Last Name:ROGALSKI
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:R
Other - Last Name:VOGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 COLUMBUS CIRCLE
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1412
Mailing Address - Country:US
Mailing Address - Phone:212-590-5580
Mailing Address - Fax:212-590-5581
Practice Address - Street 1:5 COLUMBUS CIRCLE
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1412
Practice Address - Country:US
Practice Address - Phone:212-590-5580
Practice Address - Fax:212-590-5581
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012241363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant