Individual
JOHN BOGARDUS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
310 S MANNING BLVD, ALBANY, NY 12208-1771
(518) 525-1372
(518) 525-1120
Mailing address
310 S MANNING BLVD, ALBANY, NY 12208-1771
(518) 525-1372
(518) 525-1120
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004356-1
NY
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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