Individual
LISA BOGDONOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
123 GROVE AVE, SUITE 206, CEDARHURST, NY 11516-2322
(516) 295-3353
Mailing address
123 GROVE AVE, SUITE 206, CEDARHURST, NY 11516-2322
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
180669
NY
Other
Enumeration date
01/09/2007
Last updated
07/08/2007
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