Provider Demographics
NPI:1114756236
Name:ORIA, ROGELIO ANTONIO
Entity type:Individual
Prefix:
First Name:ROGELIO
Middle Name:ANTONIO
Last Name:ORIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LARCH RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-2916
Mailing Address - Country:US
Mailing Address - Phone:219-771-6746
Mailing Address - Fax:
Practice Address - Street 1:9 LARCH RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-2916
Practice Address - Country:US
Practice Address - Phone:219-771-6746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman