Individual
DR. CRAIG M BOGDANSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
825 MERIDEN WATERBURY TPKE, SOUTHINGTON, CT 06489-4156
(860) 621-2673
(860) 621-2789
Mailing address
365 WINDING RDG, SOUTHINGTON, CT 06489-2180
(860) 620-0801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
039027
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001390278
—
CT
01
—
040039027CT02
BLUE CROSS/BLUE SHIELD
CT
Enumeration date
07/19/2005
Last updated
03/24/2009
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