Organization Name: | ANITA BODROGI D.O. |
NPI Number: | 1699962977 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANITA M. BODROGI (OWNER) |
Mailing Address: | 130 Court St Plattsburgh |
State: | NY US |
Postal Code: | 129012776 |
Phone Number: | 5185622369 |
Fax Number: | 5185622263 |
NPI Enumeration Date: | 10/01/2007 |
NPI Last Update Date: | 10/01/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 230057-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |