Individual
PAUL GEORGE BOGOSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
7715 WHITAKER AVE, PHILADELPHIA, PA 19111-2854
(215) 342-2225
(215) 342-3232
Mailing address
7801 ANITA DR, PHILADELPHIA, PA 19111-2807
(215) 342-2225
(215) 342-3232
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC002358L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0061021000
KEYSTONE HEALTH PLAN EAST
PA
01
—
088735
BLUE CROSS BLUE SHIELD
PA
05
—
0905356
—
PA
01
—
4338939
AETNA TRADITIONAL
PA
01
—
94051
AETNA HMO
PA
Enumeration date
01/18/2006
Last updated
07/09/2007
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