Provider Demographics
NPI:1144659541
Name:ERIC P ROGER MD PLLC
Entity type:Organization
Organization Name:ERIC P ROGER MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-853-2225
Mailing Address - Street 1:PO BOX 8000 DEPT 915
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0002
Mailing Address - Country:US
Mailing Address - Phone:716-389-3269
Mailing Address - Fax:716-639-1382
Practice Address - Street 1:869 DELAWARE AVE STE 1
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2099
Practice Address - Country:US
Practice Address - Phone:716-853-2225
Practice Address - Fax:716-803-6359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-06
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty