Provider Demographics
NPI:1982047445
Name:ROGERS, KATHLEEN CHANATRY (DO)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:CHANATRY
Last Name:ROGERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:S
Other - Last Name:CHANATRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:792 N MAIN ST
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:NORTH SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-1670
Mailing Address - Country:US
Mailing Address - Phone:315-423-9722
Mailing Address - Fax:315-423-9687
Practice Address - Street 1:935 JAMES ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2502
Practice Address - Country:US
Practice Address - Phone:315-422-2222
Practice Address - Fax:315-472-8497
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288383207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology