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Individual

DR. JOSEPH PETER BOGLIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 BELLE TERRE ROAD, STE 110, PORT JEFFERSON, NY 11777-1928
(631) 476-1010
(631) 642-0105
Mailing address
200 BELLE TERRE ROAD, STE 110, PORT JEFFERSON, NY 11777-1928
(631) 476-1010
(631) 642-9805

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
219312
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2120125
VYTRA
NY
01
7293637
AETNA
NY
01
7X2132
EMPIRE BCBS
NY
01
P00161349
RAILROAD MEDICARE
NY
01
PRV0004554
MONTEFIORE
NY
Enumeration date
08/12/2006
Last updated
01/31/2013
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