ROBERT JOHN ROUGHLEY (NPI# 1457563983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457563983 |
| Entity Type | Individual |
| Full Name | ROBERT JOHN ROUGHLEY |
| Practice Address |
79 Middleville Rd Northport NY 11768-2290 |
| Mailing Address |
166 Ave C Holbrook NY 11741-1417 |
| Practice Telephone | 6312614400 |
| Mailing Telephone | 6314674388 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471R0002X |
Radiologic Technologist Specialization: Radiation Therapy |
731459 | NY | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003036617 | Robert Lloyd Roughley | Dentist | 2931 N Tenaya Way, Suitte 206, Las Vegas, NV 89128-0456 | 2007-04-26 |
| Street Address |
79 MIDDLEVILLE RD |
| City | NORTHPORT |
| State | NY |
| Zip Code | 11768-2290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417958471 | David Wayne Gately | Psychologist | 79 Middleville Rd, Va Medical Center, Psychology Service (116b), Northport, NY 11768-2200 | 2005-08-02 |
| 1497356174 | Cynthia Abigail Serrano-colon | Nurse Practitioner | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-11-08 |
| 1225636020 | Jessie Ryan Poznack | Pathology | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-10-14 |
| 1356958094 | Alex Myunghwan Shin | Optometrist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-09-27 |
| 1407460470 | Kimberly Ann Smith | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-09-07 |
| 1790398634 | Simrit Kaur Virk | Optometrist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-08-29 |
| 1700499670 | Christine Palathinkal | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-08-28 |
| 1235748252 | Valerie Marie Campos | Registered Nurse | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-07-27 |
| 1124636634 | Da Som Kim | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-07-21 |
| 1518584341 | Irene Sofia Koutsidis | Social Worker | 79 Middleville Rd, Northport, NY 11768-2296 | 2020-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649753088 | Tania Morris | Developmental Therapist | 130 Main St, #1, Northport, Ny 11768, Northport, NY 11768 | 2018-09-12 |
| 1639698343 | Karen Yuan Wong | Student in an Organized Health Care Education/Training Program | 79 Middleviille Rd., Optometry 123, Northport, NY 11768 | 2017-09-13 |
| 1821514795 | Village Speech and Language Pllc | Clinic/Center | 62 Makamah Beach Rd, Northport, NY 11768 | 2017-08-22 |
| 1073960415 | Dennis Falco | Private Vehicle | 5 Captain Richards Ln, Fort Salonga, NY 11768 | 2016-05-16 |
| 1679938252 | Debra Marie Failla | Psychologist | 260 Main Street, Suite 202, Northport, NY 11768 | 2015-12-23 |
| 1649649096 | Lillian Patricia Fais | Specialist | 26 Josephine Lane, Fort Salonga, NY 11768 | 2015-09-16 |
| 1427349505 | Kathleen Ann Korwasky | Occupational Therapist | 18 Dick Court, Northport, NY 11768 | 2011-04-25 |
| 1043448822 | Gianna Rose Ferranti | Dentist | 19 Winkle Point Road, Northport, NY 11768 | 2009-06-30 |
| 1861658213 | Barbara Ann Hansen | Registered Nurse | 78 Eatons Neck Rd, Northport, NY 11768 | 2008-08-05 |
| 1902060148 | Dana Ruth Cohen | Psychiatry & Neurology | 79 Middleville Road, Bldg 64, Northport Vamc, Northport, NY 11768 | 2008-07-16 |
| Find all providers in zip 11768 | ||||
| Taxonomy Code | 2471R0002X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Radiation Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760968788 | Dominique Nyffler | Radiologic Technologist | 91 2nd St, Brooklyn, NY 11231-4803 | 2018-07-12 |
| 1073920468 | Shlomo Kalman Rosenfeld | Radiologic Technologist | 750 Lefferts Ave Apt D1, Brooklyn, NY 11203-1221 | 2014-07-17 |
| 1568733806 | Heenaparveen Rizwanahmed Contractor | Radiologic Technologist | 41 Meridian Rd, Levittown, NY 11756-4239 | 2012-01-18 |
| 1215173182 | Michael Montanez | Radiologic Technologist | 128 Ave N, Brooklyn, NY 11230 | 2008-12-26 |
| 1467519942 | Marissa Y Gayle | Radiologic Technologist | 177 New Hempstead Rd, New City, NY 10956-2430 | 2007-01-03 |
| 1023122801 | Michael Rosario | Radiologic Technologist | 985 Father Capodanno Blvd, Staten Island, NY 10306-6041 | 2006-08-18 |
| 1457364861 | Kirk Krickmier | Radiologic Technologist | 736 Craig Ave, Staten Island, NY 10307-1510 | 2006-08-15 |
| 1538634639 | Joseph Jacobo | Radiologic Technologist | 1384 Broadway, New York, NY 10018-6108 | 2018-10-04 |
| 1518320274 | Paul Dritto | Radiologic Technologist | 34 Orchard St, 2nd Floor, Massapequa, NY 11758-5721 | 2016-03-31 |
| 1700284346 | Cristina Fanita | Radiologic Technologist | 800 Poly Pl, Brooklyn, NY 11209-7104 | 2014-12-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.