Individual
VICKI REBECCA BOGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD CDN
Contact information
Practice address
4115 45TH ST, APT. 5H, SUNNYSIDE, NY 11104-1949
(718) 482-0406
(718) 482-0406
Mailing address
4115 45TH ST, APT. 5H, SUNNYSIDE, NY 11104-1949
(718) 482-0406
(718) 482-0406
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
005423-1
NY
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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