Individual
KATIE BOGUSZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
44 STATE RT 23, SUITE #6, RIVERDALE, NJ 07457-1603
(973) 248-9199
(973) 248-9299
Mailing address
44 STATE RT 23, SUITE #6, RIVERDALE, NJ 07457-1603
(973) 248-9199
(973) 248-9299
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
25MA09074600
NJ
207R00000X
Internal Medicine Physician
25MA09074600
NJ
Other
Enumeration date
04/28/2008
Last updated
01/24/2019
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